ObjectiveThe aim of this study was to investigate the prognostic significance of the serum γ-glutamyltransferase (γ-GT)-to-prealbumin ratio (GPR) and whether combining this ratio with other parameters can lead to an improved prognostic value for patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE) combined with local ablation therapy.MethodsA total of 235 HCC patients who were treated with combined therapies were retrospectively analyzed. The demographic data and clinicopathological data were collected. A fibrinogen (Fib)-GPR score of 2 was assigned to patients with elevated Fib and GPR values, and a score of 1 or 0 was assigned to patients with one or neither of these two markers, respectively. In addition, an N-score of 2 was assigned to patients with low neutrophil and high GPR values, and a score of 1 or 0 was assigned to patients with one or neither of these two markers, respectively. The optimal cutoff values and prognostic roles of GPR and other markers were identified according to the time-dependent receiver operating characteristic (ROC) curves and Youden’s index.ResultsMultiple tumors, high levels of α-fetoprotein (AFP) and Fib, as well as a high GPR, were found to be independent risk factors in recurrent patients, while multiple tumors, a low neutrophil count, and a high GPR were associated with reduced overall survival (OS) in patients with HCC who received combined therapies. Patients with a Fib-GPR score of 2 and N-GPR score of 2 had poor recurrence-free survival (RFS) and OS, respectively.ConclusionsFib-GPR and N-GPR scores may be helpful in predicting both recurrence and the prognosis of HCC patients, thereby assisting in the process to make a true clinical decision and optimize therapeutic options.

中文翻译：

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γ-谷氨酰转移酶与前白蛋白比值和其他指标的结合可能是预测接受局部消融治疗的肝细胞癌患者预后的新标志物

目的本研究旨在探讨血清γ-谷氨酰转移酶（γ-GT）与前白蛋白比值（GPR）的预后意义，以及将该比值与其他参数相结合是否可以提高肝细胞癌患者的预后价值。 (HCC)行经导管动脉化疗栓塞(TACE)联合局部消融治疗。方法对235例接受联合治疗的HCC患者进行回顾性分析。收集人口统计学数据和临床病理学数据。纤维蛋白原 (Fib)-GPR 评分为 2 分被分配给 Fib 和 GPR 值升高的患者，而 1 分或 0 分被分配给具有这两种标志物之一或没有这两种标志物的患者。此外，中性粒细胞低和 GPR 值高的患者的 N 评分为 2，1 分或 0 分分别分配给具有这两种标记中的一种​​或两种都没有的患者。根据时间依赖性受试者工作特征（ROC）曲线和约登指数确定 GPR 和其他标志物的最佳截止值和预后作用。结果多发肿瘤、高水平的甲胎蛋白（AFP）和 Fib，以及高 GPR 被发现是复发患者的独立危险因素，而多个肿瘤、低中性粒细胞计数和高 GPR 与接受联合治疗的 HCC 患者的总生存期 (OS) 降低相关。Fib-GPR 评分为 2 分和 N-GPR 评分为 2 分的患者的无复发生存期 (RFS) 和 OS 分别较差。结论 Fib-GPR 和 N-GPR 评分可能有助于预测 HCC 的复发和预后耐心，