Predictive value of and relationship between the gamma-glutamyl transpeptidase to lymphocyte ratio and CT features in hepatocellular carcinoma patients with postoperative adjuvant TACE.

PURPOSE To explore the predictive value of and the relationship between the gamma-glutamyl transpeptidase (GGT) to lymphocyte ratio (GLR) and computed tomography (CT) features in hepatocellular carcinoma (HCC) patients with postoperative adjuvant transarterial chemoembolization (PA-TACE). METHODS Between January 2012 and June 2015, 150 HCC patients who underwent adjuvant TACE after hepatectomy in the Affiliated Hospital of Nantong University were selected. Baseline parameters, laboratory values, clinical variables, and CT features (including CT values, irregular rim-like arterial phase enhancement (IRE), and CT enhanced values) were evaluated in all of the patients. The Mann-Whitney U test was performed to assess the GLR values between the patients with microvascular invasion (MVI) and those without MVI. Spearman correlation analysis was performed to evaluate the relationship between IRE and GLR. A nomogram based on the multivariate analysis was constructed. RESULTS Using multivariate analysis, GLR, MVI, α-fetoprotein levels, and IRE were found to be independent prognostic factors for overall survival (OS). In the MVI group, the GLR of patients was higher than that in the non-MVI group (z=-6.652, p<0.001). We observed a clear correlation between GLR and IRE (r=0.522, p<0.001). The nomogram was constructed and the calibration curve showed excellent predictive performance. CONCLUSIONS We observed a correlation between GLR and CT features in HCC patients. The nomogram based on clinical data, pathological data, and CT features was suggested to predict the 5-year survival of HCC patients with PA-TACE, which offers an accurate, comprehensive, and reliable evaluation for individualized treatment.