Elevated Preoperative Serum Gamma glutamyltranspeptidase Predicts Poor Prognosis for Hepatocellular Carcinoma after Liver Transplantation
Gamma glutamyltransferase (g GGT) is a membrane bound enzyme that is involved in biotransformation, nucleic acid metabolism, and tumourigenesis. Elevated serum g GGT levels are related to an increased cancer risk and worse prognosis in many cancers. In the present study, we evaluated the prognostic value of preoperative serum g GGT in patients with hepatocellular carcinoma (HCC) who underwent liver transplantation (LT) A total of 130 HCC patients after LT were included in the study. The optimal cut off value of g GGT was 128U/L by receiver operating characteristic analysis, with a sensitivity and specificity of 60.0% and 72.9% respectively. Elevated preoperative serum g GGT was significantly associated with high alpha fetoprotein (AFP) large tumor size, and macro and micro vascular invasion. The 1 3 5 year disease free survival (DFS) and overall survival (OS) rates of HCC patients in the g GGT 128U/L group were poorer than those in the g GGT 128U/L group. Stratification analysis revealed that g GGT exhibited a greater predictive value for DFS and OS in HCC patients beyond the Milan criteria and no macro vascular invasion. In conclusion, elevated preoperative serum g GGT was significantly associated with advanced tumor stage and aggressive tumor behaviors, and serum g GGT can be considered as a prognostic factor for HCC patients after LT, especially for patients beyond the Milan criteria or without macro vascular invasion.
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