title: Model based on γ-glutamyltransferase and alkaline phosphatase for hepatocellular carcinoma prognosis.
abstract: OBJECTIVE
  To determine the prognostic value of alkaline phosphatase (ALP) and γ-glutamyltransferase (GGT) for hepatocellular carcinoma (HCC) .
  
  
  METHODS
  We analyzed the outcome of 172 HCC patients who underwent liver resection. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of ALP and GGT. Then, preoperative risk factors for survival were evaluated by multivariate analysis. Based on the significant factors, a prognostic score model was established.
  
  
  RESULTS
  By ROC curve analysis, ALP > 120 U/L and GGT > 115 U/L were considered elevated. Overall survival (OS) and tumor-free survival (TFS) for patients with elevated ALP and GGT were significantly worse than for patients with ALP and GGT within the normal range. Multivariate analysis showed that the elevated levels of ALP, GGT and tumor size were independent prognostic factors. Giving each positive factor as a score of 1, we established a preoperative prognostic score model. The 5-year OS for patients with a score of 0, 1, 2 and 3 were 84.0%, 45.9%, 44.1% and 0%, respectively, while the TFS was 80.6%, 40.0%, 38.8% and 0%, respectively. When combining patients with scores of 1 and 2 into the middle risk group, and patients with scores of 0 and 3 into the low-risk and high-risk groups, respectively, different outcomes would be significantly distinguished by the risk groups.
  
  
  CONCLUSIONS
  Elevated ALP and GGT levels were risk predictors in HCC patients. Our prognostic model might vary the outcomes of patients from different risk groups.
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Xin-Sen
authors.initials: XS
authors.lastname: Xu
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wan
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Si-Dong
authors.initials: SD
authors.lastname: Song
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Run-Chen
authors.initials: RC
authors.lastname: Miao
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Zhou
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Ling-Qiang
authors.initials: LQ
authors.lastname: Zhang
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Qu
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Si-Nan
authors.initials: SN
authors.lastname: Liu
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Yue-Lang
authors.initials: YL
authors.lastname: Zhang
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Ya-Feng
authors.initials: YF
authors.lastname: Dong
authors.affiliation: Xin-Sen Xu, Yong Wan, Si-Dong Song, Wei Chen, Run-Chen Miao, Yan-Yan Zhou, Ling-Qiang Zhang, Kai Qu, Si-Nan Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood*; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D003661:Decision Support Techniques; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D005723:gamma-Glutamyltransferase; C554782:gamma-glutamyltransferase, human; D000469:Alkaline Phosphatase
keywords: Alkaline phosphatase; Hepatocellular carcinoma; Prognosis; γ-Glutamyltransferase