Gamma-glutamyl transpeptidase-to-platelet ratio and the fibrosis-4 index in predicting hepatitis B virus-related hepatocellular carcinoma development in elderly chronic hepatitis B patients in China: A single-center retrospective study

• Published in: Medicine (Baltimore) 2019-12, Vol.98 (50), p.e18319-e18319
• Main Authors: Zhu, Yun-Feng, Tan, Yi-Fei, Xu, Xi, Zheng, Jin-Li, Zhang, Bo-Han, Tang, Huai-Rong, Yang, Jia-Yin
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers, Tumor; Blood Platelets - pathology; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - etiology; China - epidemiology; Female; Follow-Up Studies; gamma-Glutamyltransferase - blood; Hepatitis B virus; Hepatitis B, Chronic - blood; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - virology; Humans; Incidence; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Neoplasms - blood; Liver Neoplasms - diagnosis; Liver Neoplasms - etiology; Male; Middle Aged; Observational Study; Platelet Count; Retrospective Studies; Risk Factors; ROC Curve; Time Factors
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000018319

Gamma-glutamyl transpeptidase-to-platelet ratio (GPR) and fibrosis-4 (FIB-4) index have been reported to be useful predictors in predicting hepatocellular carcinoma (HCC) development in chronic hepatitis B (CHB) patients. However, their predictive performances on HCC development have not been validated in elderly patients. Thus, the aim of this study was to evaluate the predictive values of the GPR and FIB-4 index on HCC in elderly CHB patients with in China.Between January 2007 and December 2016, 1011 CHB patients older than 60 years were enrolled in the study, and their data were retrospectively analyzed. Receiver-operating characteristic (ROC) curve analysis was used to determine the optimal cutoff points of GPR and the FIB-4 index. Cumulative HCC incidence rates were calculated by the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariate analyses were performed to detect risk factors for HCC development. The prediction performances of GPR and FIB-4 index were compared based on time-dependent ROC analyses.After a median follow-up of 6.8 (interquartile range 3.9-8.4) years, 39 (3.9%) patients developed HCC. The ROC analysis of GPR and the FIB-4 index at the 5-year time point revealed that the optimal cutoff point was 0.23 for GPR and 4.15 for the FIB-4 index. When stratified by low and high GPR values and FIB-4 indices, the patients' subgroups showed significantly different cumulative incidences of HCC. The multivariate analysis revealed that high GPR (hazard ratio [HR] 4.224; 95% confidence interval [CI] 1.891-9.434, P