Utility of gamma-glutamyl transpeptidase to lymphocyte count ratio in predicting prognosis of patients with oral cancer: A prospective cohort study in Southeastern China.

Abstract

To assess the prognostic role of gamma-glutamyl transpeptidase to lymphocyte count ratio (GLR) and develop a prognostic nomogram for patients with oral cancer. A prospective cohort (n=1011) was conducted during July 2002 to March 2021 in Southeastern China. The median follow-up time was 3.5 years. Multivariate Cox regression (OS: HR=1.51, 95% CI: 1.04, 2.18) and Fine-Gray model (DSS: HR=1.68, 95% CI: 1.14, 2.49) both showed that high GLR could act as an indicator of poor prognosis. A nonlinear dose-response relationship was observed between continuous GLR and the risk of all-cause mortality (p for overall=0.028, p for nonlinear=0.048). Compare with TNM stage, time-dependent ROC curve proved that GLR-based nomogram model performs better in predicting prognosis (the area under curve for 1-, 3-, and 5-years mortality: 0.63, 0.65, and 0.64 vs. 0.76, 0.77, and 0.78, p < 0.001). GLR might be a useful tool in predicting prognosis for patients with oral cancer.