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摘要：
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摘要：目的 探讨肝细胞癌（hepatocellular carcinoma，HCC）患者术前γ-谷氨酰转肽
酶与淋巴细胞计数比值（gamma-glutamyl transferase to lymphocyte count ratio，GLR）
对预后的影响。方法 回顾性分析惠州市第三人民医院2011年6月至2017年4月收治的
286例HCC患者的临床资料，按照GLR中位数将患者分为（GLR ＞ 42，132例）和低
GLR组（GLR ≤ 42，154例），比较两组患者性别、年龄、肿瘤大小、肿瘤数目等临
床资料，采用Kaplan-Meier生存曲线比较两组总生存期（overall survival，OS）和无复
发生存期（relapse free survival，RFS）。采用Cox多因素回归分析影响HCC患者预后
的独立危险因素。结果 高GLR组患者肝硬化（87.88% vs 78.57%）、肿瘤大小≥ 5 cm
（51.52% vs 22.08%）、微血管侵犯（63.34% vs 37.01%）、白蛋白≤ 35 g/L（9.09% vs
1.95%）、ALT ＞ 44 U/L（47.73% vs 14.94%）、淋巴细胞计数≤ 1.3 × 109
/L（71.21%
vs 32.47%）、血小板计数≤ 100 × 109
/L（30.30% vs 18.18%）、NLR ＞ 3（81.82% vs
65.58%）所占百分比均高于低GLR组患者（P均＜ 0.05）。高GLR组患者RFS为28.1个
月，OS为33.4个月，分别低于低GLR组患者的46.9个月和55.8个月，差异均有统计学意
义（P均＜ 0.05）。Cox多因素回归分析表明：肝硬化、肿瘤大小≥ 5 cm、ALT ＞ 44 U/L、
GLR ＞ 42是影响HCC患者术后RFS和OS的独立危险因素。结论 术前GLR可作为HCC
患者预后评价的一项指标。
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Abstract: Objective To investigate the effect of preoperative gamma-glutamyl transferase to
lymphocyte count ratio (GLR) on prognosis of patients with hepatocellular carcinoma (HCC).
Methods The clinical data of 286 patients with HCC admitted to Huizhou Third People’s
Hospital from June 2011 to April 2017 were analyzed retrospectively. According to the median
of GLR, the patients were divided into high GLR group (GLR ＞ 42, 132 cases) and low GLR
group (GLR ≤ 42, 154 cases). Gender, age, tumor size, tumor number, etc. of the two groups
were compared. The overall survival (OS) and relapse-free survival (RFS) of the two groups
were compared by Kaplan-Meier survival curves. Cox multivariate regression was used to
analyze the independent risk factors affecting the outcome of HCC patients. Results The
percentages of liver cirrhosis (87.88% vs 78.57%), tumor size ≥ 5 cm (51.52% vs 22.08%),
microvascular invasion (63.34% vs 37.01%), albumin ≤ 35 g/L (9.09% vs 1.95%), ALT ＞
44 U/L (47.73% vs 14.94%), lymphocyte count ≤ 1.3 × 109
/L (71.21% vs 32.47%), platelet
count ≤ 100 × 109
/L (30.30% vs 18.18%) and NLR ＞ 3 (81.82% vs 65.58%) of patients in
high GLR group were higher than those of low GLR group (all P ＜ 0.05). RFS and OS of the
high GLR group were 28.1 months and 33.4 months, which were lower than those of the low
GLR group (46.9 and 55.8 months) respectively, the differences were statistically significant
(all P ＜ 0.05). Cox multivariate analysis showed that liver cirrhosis, tumor size ≥ 5 cm, ALT ＞
44 U/L and GLR ＞ 42 were the independent risk factors for postoperative RFS and OS of
patients with HCC. Conclusions Preoperative GLR can be used as a prognostic indicator for
HCC patients.
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