Effects of various interventions on the occurrence of macrovascular invasion of hepatocellular carcinoma after the baseline serum γ-glutamyltransferase stratification
Authors Liu Y, Zhang Q, Yang X, Li Y, Zhu B, Niu S, Huang Y, Hu Y, Wang X
Received 17 August 2018
Accepted for publication 29 January 2019
Published 28 February 2019 Volume 2019:12 Pages 1671—1679
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Ms Justinn Cochran
Peer reviewer comments 3
Editor who approved publication: Dr Sanjay Singh
Yao Liu,1 Qun Zhang,1 Xue Yang,1 Yuxin Li,1 Bingbing Zhu,2 Shuaishuai Niu,1 Yunyi Huang,2 Ying Hu,1 Xianbo Wang1
1Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People’s Republic of China; 2Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, People’s Republic of China
Background: Elevated serum γ-glutamyltransferase (γ-GT) levels are related to an increased cancer risk and worse prognosis in many cancers. We evaluated the effects of γ-GT stratification on the occurrence of macrovascular invasion (MVI) in patients with hepatocellular carcinoma (HCC) who underwent hepatic resection (HR), transcatheter arterial chemoembolization (TACE), or TACE combined with radiofrequency ablation (TACE-RFA).
Patients and methods: A total of 903 patients with HCC in Barcelona Clinic Liver Cancer Stage A or B were included. Of these patients, 118 underwent HR, 445 underwent TACE-RFA, 256 underwent TACE, and 84 patients received conservative treatment only (control group). γ-GT, albumin, γ-fetoprotein, and intervention were selected as significant predictive factors for MVI in 1 year by forward selection. The optimal cutoff value of γ-GT was 39 IU/L according to receiver operating characteristic analysis, with a sensitivity and specificity of 87.0% and 45.6%, respectively.
Results: The 1-year MVI incidence of patients with HCC in the group with γ-GT ≥39 IU/L was higher than that of the group with γ-GT <39 IU/L treated with HR, TACE-RFA, or TACE (P=0.0166, P=0.0041, and P<0.001, respectively). The MVI rates at 1 year were similar in the group with γ-GT ≥39 IU/L that underwent HR, TACE-RFA, or TACE and the control group (P=0.4402, P=0.2214, and P=0.4159, respectively). Different effects of various treatments with γ-GT <39 IU/L group on the occurrence of MVI are not significant (P=0.5167). However, the incidence of MVI after TACE was significantly higher than that after HR or TACE-RFA in γ-GT ≥39 IU/L group (P=0.0253).
Conclusion: Baseline serum γ-GT stratification may help select the appropriate treatment to reduce the MVI incidence.
Keywords: gamma-glutamyltransferase, macroscopic vascular invasion, liver cancer
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