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Gamma‐glutamyl transpeptidase‐to‐platelet ratio is an independent predictor of hepatitis B virus‐related liver cancer
Author(s) -
Park Yong Eun,
Kim Beom Kyung,
Park Jun Yong,
Kim Do Young,
Ahn Sang Hoon,
Han KwangHyub,
Han Sojung,
Jeon Mi Young,
Heo Ja Yoon,
Song Kijun,
Kim Seung Up
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13653
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , interquartile range , hazard ratio , hepatitis b virus , risk factor , population , cumulative incidence , confidence interval , immunology , cohort , virus , environmental health
Background and Aim Gamma‐glutamyl transpeptidase‐to‐platelet ratio (GPR) can evaluate the degree of liver fibrosis. We investigated whether GPR can predict the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients. Methods We retrospectively evaluated 1109 CHB patients that were enrolled between 2006 and 2012, and all patients had available data for the assessment of GPR at enrollment. Three risk groups were defined according to tertile stratification: GPR < 0.05, low‐risk ( n = 370 [33.4%]); GPR 0.05–0.24, intermediate‐risk ( n = 370 [33.4%]); and GPR > 0.24, high‐risk ( n = 369 [33.2%]). The predictive accuracy of GPR, fibrosis‐4 (FIB‐4), and aspartate transaminase‐to‐platelet ratio index (APRI) in predicting HCC development was tested. Results The median age of the study population (746 men and 363 women) was 50 years. During the follow‐up period (median, 32 months; interquartile range, 19–57 months), 69 (6.2%) patients developed HCC. Together with age, male gender, diabetes mellitus, antiviral therapy, serum albumin, and alpha‐fetoprotein, the relative risk of HCC development significantly increased from low‐risk to high‐risk GPR groups (hazard ratio [HR], up to 29.5; adjusted HR, up to 10.6; all P < 0.05). In addition, FIB‐4 was calculated to be a significantly high relative risk of HCC development (HR, up to 20.1; adjusted HR, up to 7.3; all P < 0.05), whereas APRI was not ( P = 0.168). The cumulative incidence of HCC development was significantly different among three risk groups ( P < 0.001, log‐rank test). Conclusions This study suggests that GPR can be used as a noninvasive marker to assess the risk of HCC development in CHB patients.