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Gamma-glutamyl transpeptidase-to-platelet ratio is an independent predictor of hepatitis B virus-related liver cancer

 Yong Eun Park  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang‐Hyub Han  ;  Sojung Han  ;  Mi Young Jeon  ;  Ja Yoon Heo  ;  Kijun Song  ;  Seung Up Kim 
 Journal of Gastroenterology and Hepatology, Vol.32(6) : 1221-1229, 2017 
Journal Title
 Journal of Gastroenterology and Hepatology 
Issue Date
Biomarkers, Tumor/blood* ; Carcinoma, Hepatocellular/diagnosis* ; Carcinoma, Hepatocellular/etiology* ; Female ; Follow-Up Studies ; Hepatitis B, Chronic/complications* ; Humans ; Liver Neoplasms/diagnosis* ; Liver Neoplasms/etiology* ; Male ; Middle Aged ; Platelet Count* ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Time Factors ; gamma-Glutamyltransferase/blood*
chronic hepatitis B ; gamma-glutamyl transpeptidase-to-platelet ratio ; hepatitis B virus ; hepatocellular carcinoma ; liver fibrosis ; noninvasive predictor
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Yong Eun(박용은)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Jeon, Mi Young(전미영) ORCID logo https://orcid.org/0000-0002-3980-4503
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
Han, Sojung(한소정)
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