Non-linear relationship of gamma-glutamyl transpeptidase to lymphocyte count ratio with the recurrence of hepatocellular carcinoma with staging I-II: a retrospective cohort study

Background: High recurrence rate was a major factor for the poor postoperative prognosis of hepatocellular carcinoma (HCC) patients. The present study was intended to evaluate the association of gamma-glutamyl transpeptidase to lymphocyte count ratio (GLR) and the recurrence of HCC with staging I-II in Chinese.

Methods: The retrospective cohort data was derived from the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2018 on 496 patients who underwent radical resection of HCC with staging I-II. Multivariable Cox regression models were used to determine hazard ratios (HR) and 95% confidence interval (CI) for the recurrence of HCC with staging I-II of each GLR tertile category. The restricted cubic spline model was used to find out the threshold effect.

Results: With the low tertile of GLR as the reference, multivariable-adjusted HR and 95% CI of the middle and high tertile categories were 1.748 (1.170-2.612) and 2.078 (1.339-3.227). In addition, there was a positive correlation (HR 1.002; 95% CI 1.001-1.004) and a non-liner relationship was found, whose point was 27.5. When the GLR was less than 27.5, the risk of recurrence increased, obviously with the increase in GLR levels (HR 1.041; 95% CI 1.014-1.068).

Conclusions: The GLR was independently associated with the recurrence of HCC patients with staging I-II. Furthermore, the relationship was positive and no-linear.