Gamma-glutamyl Transpeptidase To Platelet Ratio Research Articles

Gamma-glutamyltranspeptidase to platelet ratio and albumin to gamma-glutamyltranspeptidase between degrees of the Barcelona clinic liver cancer on hepatocellular carcinoma patients in Haji Adam Malik general hospital Medan during 2015-2016

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver and occurs predominantly in apatient with underlying chronic liver disease and cirrhosis. HCC presented at an advancedstage with right-upper-quadrant pain, weight loss, and signs of decompensated liver disease; it is now increasingly recognized atmuch measurements of the biomarker. Some of them are Gamma-glutamyltranspeptidase to platelet ratio (GPR) and Albumin to Gamma- glutamyltranspeptidase (AGR). This study aimed to know the difference between GPR and AGR between degrees of the Barcelona Clinic Liver cancer (BCLC) on HCC patients. A retrospective study was carried out in 166 outpatient and inpatient HCC in Haji Adam Malik General Hospital from January 2015–December2016.Kruskal-Wallis test showed that there is no significant differentiation of GPR between degrees of BCLC (p=0.23), but there is a considerable differentiation of AGR between degrees of BCLC (p=0.032).

Aspartate transaminase to platelet ratio index and gamma-glutamyl transpeptidase-to-platelet ratio outweigh fibrosis index based on four factors and red cell distribution width-platelet ratio in diagnosing liver fibrosis and inflammation in chronic hepatitis B.

The benefits of using serum markers to diagnose stages of liver disease in chronic hepatitis B (CHB) patients are controversial. We conducted a study to compare the clinical significance of four markers in evaluating liver inflammation and fibrosis in CHB patients. A total of 323 treatment-naive CHB patients who received a liver biopsy and routine laboratory testing were enrolled in our study. We used the Scheuer scoring system as a pathological standard for diagnosing liver inflammation and fibrosis. The diagnostic performance of the fibrosis index based on four factors (FIB-4), the aspartate transaminase to platelet ratio index (APRI), the gamma-glutamyl transpeptidase-to-platelet ratio (GPR), and the red cell distribution width-platelet ratio (RPR) were analyzed with receiver-operating characteristic curves (ROC). No significant differences among the four indexes for diagnosing significant fibrosis (S≥2) was found, while APRI and GPR were superior to FIB-4 and RPR in diagnosing moderate (G≥2), severe (G≥3) inflammation, and severe fibrosis (S≥3). The AUROCs for diagnosing G≥2 and G≥3 were 0.732 and 0.861 for APRI, 0.726 and0.883 for GPR, 0.703 and0.705 for FIB-4, and 0.660 and 0.747 for RPR, respectively. The AUROCs for diagnosing S≥2 and S≥3 were0.724 and 0.799 for APRI, 0.714 and0.801 for GPR, 0.683 and0.730 for FIB-4, and 0.643 and 0.705 for RPR, respectively. APRI and GPR were more effective than FIB-4 and RPR at diagnosing liver inflammation and fibrosis.

Analysis of genotype 1b hepatitis C virus NS5A resistance-associated variants and its related factors

Objective To analyze hepatitis C virus genotype (HCV GT)1b NS5A resistance-associated variants (RAV) and its related factors, and to provide references for direct-acting antivirals (DAA) agent selection and application. Methods From January 2017 to July 2017, 53 hepatitis C patients were selected from the Department of Infectious Diseases of Henan Province People's Hospital. The mutations of L31M and Y93H in NS5A RAV were analyzed in 43 HCV GT1b patients, and their correlations with hepatitis C virus, liver function, platelet and liver fibrosis diagnostic model [APRI, gamma-glutamyl transpeptidase to platelet ratio (GPR), FIb-4] were analyzed. The quantitative data were compared by two independent samples t test, and the qualitative data were compared by chi square test. Results Fifty-three subjects were enrolled, including 43 GT1b (9 males and 34 females) and 10 GT2a (2 males and 8 females). No other genotype was detected. The incidence of NS5A RAV in 43 HCV GT1b patients was 13.9% (6/43), of which L31M and Y93H were 1/43 (2.3%) and 5/43 (11.6%) with no significant difference (χ2=1.500, P=0.219). There were no significant differences in HCV RNA, ALT, AST, albumin, platelets and age between patients with or without mutation (all P>0.05). Conclusions The incidence of NS5A RAV in HCV GT1b patients is high, but not affected by virus, biochemical factors and liver fibrosis. The detection of NS5A RAV before HCV treatment is helpful for rational selection of DAA, which could reduce the drug resistance. Key words: Hepacivirus; Mutation; Resistance-associated variants

Gamma-glutamyl transpeptidase-to-platelet ratio predicts the prognosis in HBV-associated acute-on-chronic liver failure

BackgroundThe gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a new noninvasive marker for assessing liver fibrosis. We aimed to evaluate the performance of GPR for prediction of 90-day mortality in patients with acute-on-chronic liver failure (ACLF). MethodsA total of 355 patients with HBV-associated ACLF were enrolled from two clinical centers and divided into training group (n=210) and validation group (n=145). Potential risk factors for 90-day mortality were analyzed. ResultsAge, MELD score and GPR were independent risk factors associated with ACLF prognosis. A new scoring system (MELD-GPR) was developed. MELD-GPR=9.211−0.029×age−0.290×MELD−0.460×GPR. For ACLF patients with liver cirrhosis, the area under the receiver operating characteristic curve (AUROC) of MELD-GPR was 0.788, which was significantly higher than that of MELD and MELD-Na (0.706 and 0.666, respectively). Patients were stratified into three groups according to MELD-GPR scores (high risk: <−0.19, intermediate risk: −0.19–0.95, and low risk: >0.95), and the high-risk group (MELD-GPR<−0.19) had a poor prognosis (P<0.01). For ACLF patients without liver cirrhosis, MELD-GPR<0.95 predicted a poor prognosis. ConclusionsIncorporating GPR into MELD may provide more accurate survival prediction in patients with HBV-ACLF.

Gamma-glutamyl-transpeptidase to platelet ratio is not superior to APRI,FIB-4 and RPR for diagnosing liver fibrosis in CHB patients in China

The gamma-glutamyl transpeptidase to platelet ratio (GPR) is a novel index to estimate liver fibrosis in chronic hepatitis B (CHB). Few studies compared diagnostic accuracy of GPR with other non-invasive fibrosis tests based on blood parameters. We analyzed diagnostic values of GPR for detecting liver fibrosis and compared diagnostic performances of GPR with APRI (aspartate aminotransferase-to-platelet ratio index), FIB-4 (fibrosis index based on the four factors), NLR (neutrophil-to-lymphocyte ratio), AAR (aspartate aminotransferase/alanine aminotransferase ratio) and RPR (red cell distribution width-to-platelet ratio) in HBeAg positive CHB and HBeAg negative CHB. We found AUROCs of GPR in predicting significant liver fibrosis, advanced liver fibrosis and liver cirrhosis were 0.732 (95% CI 0.663 to 0.801), 0.788 (95% CI 0.729 to 0.847) and 0.753 (95% CI 0.692 to 0.814), respectively. Further comparisons showed the diagnostic performance of GPR was not significantly different with APRI, FIB-4 and RPR in identifying significant fibrosis, advanced fibrosis and cirrhosis, but it was significantly superior to AAR and NLR in both HBeAg positive CHB and HBeAg negative CHB. In conclusion, GPR does not show advantages than APRI, FIB-4 and RPR in identifying significant liver fibrosis, advanced liver fibrosis and liver cirrhosis in both HBeAg positive CHB and HBeAg negative CHB in China.

Gamma-glutamyl transpeptidase-to-platelet ratio is an independent predictor of hepatitis B virus-related liver cancer.

Gamma-glutamyl transpeptidase-to-platelet ratio (GPR) can evaluate the degree of liver fibrosis. We investigated whether GPR can predict the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients. We retrospectively evaluated 1109 CHB patients that were enrolled between 2006 and 2012, and all patients had available data for the assessment of GPR at enrollment. Three risk groups were defined according to tertile stratification: GPR<0.05, low-risk (n=370 [33.4%]); GPR 0.05-0.24, intermediate-risk (n=370 [33.4%]); and GPR>0.24, high-risk (n=369 [33.2%]). The predictive accuracy of GPR, fibrosis-4 (FIB-4), and aspartate transaminase-to-platelet ratio index (APRI) in predicting HCC development was tested. The median age of the study population (746 men and 363 women) was 50years. During the follow-up period (median, 32months; interquartile range, 19-57months), 69 (6.2%) patients developed HCC. Together with age, male gender, diabetes mellitus, antiviral therapy, serum albumin, and alpha-fetoprotein, the relative risk of HCC development significantly increased from low-risk to high-risk GPR groups (hazard ratio [HR], up to 29.5; adjusted HR, up to 10.6; all P<0.05). In addition, FIB-4 was calculated to be a significantly high relative risk of HCC development (HR, up to 20.1; adjusted HR, up to 7.3; all P<0.05), whereas APRI was not (P=0.168). The cumulative incidence of HCC development was significantly different among three risk groups (P<0.001, log-rank test). This study suggests that GPR can be used as a noninvasive marker to assess the risk of HCC development in CHB patients.

Accuracy of M2BPGi, compared with Fibro Scan\xae, in analysis of liver fibrosis in patients with hepatitis C

BackgroundMac-2 Binding Protein Glycosylation isomer (M2BPGi) is a novel serological glyco-biomarker for staging liver fibrosis. Here, we aimed to evaluate the efficiency of serum M2BPGi in identifying liver fibrosis stages in Chinese patients with chronic hepatitis C infection.MethodsSerum M2BPGi levels were evaluated in 680 patients with chronic hepatitis C and 164 healthy controls who underwent the Fibro Scan® test of liver fibrosis. The diagnostic accuracy of serum M2BPGi values was compared to that of other fibrosis markers, including Fibro Scan®, the aspartate transaminase to platelet ratio index (APRI), the fibrosis index based on four factors (FIB4), and the gamma-glutamyltranspeptidase to platelet ratio (GPR).ResultsAmong the chronic hepatitis C patients, the median serum M2BPGi level increased with increasing fibrosis score as follows: 0.88 (≤F2), 1.70 (F2/F3), and 5.68 (cirrhosis). M2BPGi concentrations could also distinguish between healthy controls (0.38 ± 0.24) and hepatitis C patients (1.57 ± 2.28). After adjusting for potential confounders, M2BPGi was the most significant factor associated with the liver stiffness measurement (effect size = 0.275, P < 0.001). The optimum cutoff values of serum M2BPGi for patients with F2 and F4 were 0.945 and 1.355, respectively. The area under the curve of serum M2BPGi for prediction of significant fibrosis (F ≥ 4) using was comparable to that of APRI (0.892 vs. 0.873), while it was superior to that of other alternative markers, including FIB4 (0.818) and GPR (0.851). Compared with other non-invasive markers, M2BPGi had the greatest specificity for diagnosing cirrhosis and cirrhosis in hepatitis C patients.ConclusionsOur results suggest that the level of serum M2BPGi would be a simple and reliable diagnostic tool for identifying liver fibrosis stage in Chinese patients with chronic hepatitis.

The gamma-glutamyl transpeptidase to platelet ratio for non-invasive assessment of liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease

Background/AimThe gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a novel serum model, which was reported more accurate than aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) for diagnosing significant fibrosis and cirrhosis in HBV mono-infection in West Africa. We aimed to evaluate the diagnostic performance of GPR for liver fibrosis in patients with chronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD).ResultsOf 131 patients, 41 (31.3%), 20 (15.3%), and 10 (7.6%) were classified as having significant fibrosis, severe fibrosis and cirrhosis, respectively. To predict significant fibrosis, the AUROC of GPR was higher than that of APRI (0.86 vs 0.75, p = 0.001) and FIB-4 (0.86 vs 0.66, p < 0.001). To predict severe fibrosis, the AUROC of GPR was also higher than that of APRI (0.89 vs 0.77, p = 0.002) and FIB-4 (0.89 vs 0.72, p = 0.001). To predict cirrhosis, no difference was found between the AUROC of GPR and that of APRI (0.92 vs 0.86, p = 0.104).Materials and Methods131 patients with CHB-NAFLD were included, and the diagnostic performances of GPR, APRI and FIB-4 were compared by receiver operating characteristic (ROC) curves and the area under ROC curves (AUROCs).ConclusionsThe GPR could be used as a non-invasive marker to predict liver fibrosis and cirrhosis in CHB-NAFLD individuals.

The Gamma-Glutamyl-Transpeptidase to Platelet Ratio Does not Show Advantages than APRI and Fib-4 in Diagnosing Significant Fibrosis and Cirrhosis in Patients With Chronic Hepatitis B: A Retrospective Cohort Study in China.

The gamma-glutamyl-transpeptidase to platelet ratio (GPR) is a new liver fibrosis model, which is reported to be more accurate than aspartate transaminase (AST) to platelet ratio index (APRI) and fibrosis index based on the four factors (Fib-4) for diagnosing significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB) in West Africa.The aim of this study is to assess the diagnostic accuracy of GPR for significant fibrosis and cirrhosis in Chinese CHB patients, and explore whether GPR deserves to be popularized in China.A total of 372 CHB patients who underwent liver biopsies and routine laboratory tests were retrospectively studied. The Scheuer scoring system was adopted as the pathological standard of liver fibrosis. Using liver histology as a gold standard, the diagnostic accuracies of GPR, APRI, and Fib-4 for significant fibrosis and cirrhosis are evaluated and compared by the receiver operating characteristic (ROC) curves and the area under the ROC curves (AUROCs).Of these 372 patients, 176 (47.3%), 129 (34.7%), and 72 (19.4%) were classified as having significant fibrosis (≥ S2), severe fibrosis (≥ S3), and cirrhosis (S4), respectively. The AUROCs of GPR for significant fibrosis (0.72 vs. 0.78; P = 0.01), severe fibrosis (0.75 vs. 0.80; P = 0.04), and cirrhosis (0.78 vs. 0.83; P = 0.02) were lower than those of APRI. The AUROCs of GPR and Fib-4 for diagnosing significant fibrosis (0.72 vs. 0.70; P = 0.29), severe fibrosis (0.75 vs. 0.73; P = 0.33), and cirrhosis (0.78 vs. 0.75; P = 0.38) were comparable.GPR is a new serum diagnostic model for liver fibrosis and cirrhosis, but does not show advantages than APRI and Fib-4 in identifying significant fibrosis, severe fibrosis, and cirrhosis in CHB patients in China.

The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa

BackgroundSimple and inexpensive non-invasive fibrosis tests are highly needed but have been poorly studied in sub-Saharan Africa.MethodsUsing liver histology as a gold standard, we developed a novel index using routine...

Cooley's anaemia in a Maltese child.

<h3>Background</h3> Hepatocellular carcinoma (HCC) is an aggressive disease with high recurrence rate. However, current staging systems were lack of predictive capacity for HCC recurrence after hepatic resection. We aimed to develop prognostic nomograms based on inflammation-related markers for HCC patients underwent hepatectomy. <h3>Methods</h3> We retrospectively recruited 1350 surgically treated HCC patients from two medical centres between November 2003 and December 2017. All established inflammation-related markers were enrolled in analysis for selecting the best in predicting recurrence-free survival (RFS) and overall survival (OS). Independent prognostic factors were identified by cox regression analyses. Nomograms for estimating the probability of 1-, 2-, 3-year RFS and OS were established, and validated internally and externally. The performance, discrimination and calibration of nomograms were assessed, and compared with conventional staging systems including Barcelona Clinic Liver Cancer (BCLC) and 7^th American Joint Committee on Cancer (AJCC). <h3>Results</h3> Gamma-glutamyl transpeptidase to platelet ratio (GPR) was the only inflammation-related factor that independently correlated with both RFS and OS. GPR, international normalized ratio (INR), alpha-fetoprotein (AFP), microvascular invasion, satellite lesions, tumour number, tumour diameter and macrovascular invasion were used to construct nomogram for RFS while GPR, AFP, microvascular invasion, satellite lesions and macrovascular invasion were for OS (figure 1). In the training cohort, the C-index of nomogram was 0.713 (95% confidence interval [CI], 0.690–0.738) for RFS and 0.774 (95%CI, 0.747–0.801) for OS. These results received both internal and external validation with C-index of 0.707 (95%CI, 0.662–0.753) and 0.710 (95%CI, 0.665–0.756) for RFS, and 0.747 (95%CI, 0.686–0.807) and 0.711 (95%CI, 0.641–0.780) for OS, respectively. The calibration curves for RFS and OS rates were all well-matched with the standard lines. The nomograms showed superior accuracy to existed staging systems (<i>P</i>&lt;0.001). <h3>Conclusions</h3> The novel nomograms based on preoperative inflammation-related markers are of high efficacy in predicting survival of HCC patients after hepatectomy, which will be valuable in guiding postoperative interventions and follow-ups.