Preoperative High Serum Glutamate Dehydrogenase Level can Predict Recurrence of Hepatitis B Virus-Related Hepatocellular Carcinoma

Abstract

Background: High glutamate dehydrogenase (GLDH) levels are associated with hepatocellular carcinogenesis. This study investigated the value of preoperative serum GLDH levels in predicting postoperative recurrence in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods: In total, 176 patients with HBV-related HCC who underwent hepatectomy were retrospectively evaluated. The optimal GLDH cut-off value to predict recurrence was determined using the receiver operating characteristic curve (ROC) model. The relationship between GLDH level and clinicopathological markers was investigated. Finally, risk variables for tumor recurrence were identified, and the value of GLDH level in predicting disease-free survival (DFS) of patients was evaluated. Results: The optimal cut-off value of GLDH level was 11.2 U/L (area under the curve, 0.676;95% confidence interval, 0.597–0.754), which was used to divide patients into high (>11.2 U/L) and low (≤11.2 U/L) GLDH groups. High GLDH levels were associated with older age, multiple tumors, larger tumor diameter, higher alpha-fetoprotein (AFP) levels, vascular invasion, higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and advanced Barcelona Clinic Liver Cancer stage (all p < 0.05). High GLDH (>11.2 U/L) was an independent predictor of DFS (p < 0.001). Furthermore, the 1-, 2-, and 3-year DFS rates in patients with GLDH >11.2 U/L were significantly shorter than those in patients with GLDH ≤11.2 U/L (35.6%, 13.3%, and 10.0% vs. 74%, 56.5%, and 47.2%, p < 0.001). A sensitivity analysis of patients divided into high (>6.25 U/L) and low (≤6.25 U/L) GLDH groups according to the median GLDH value was also conducted, and the results were consistent with the main analyses. Conclusions: GLDH might be a potential recurrence predictor in HBV-related HCC patients undergoing hepatectomy.