J Cancer 2019; 10(15):3494-3500. doi:10.7150/jca.29499 This issue

Research Paper

High preoperative serum globulin in hepatocellular carcinoma is a risk factor for poor survival

Wenjie Zhang1,2,3*, Guangyan Zhangyuan2*, Fei Wang2,3*, Haitian Zhang1,3, Decai Yu1, Jincheng Wang2,3, Kangpeng Jin1,3, Weiwei Yu1,2, Yang Liu1,3, Beicheng Sun2,3✉

1. Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210029, Jiangsu Province, P.R.China
2. Department of Hepatobiliary Surgery of Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, China.
3. Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R.China.
*The authors contributed equally to this work

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Zhang W, Zhangyuan G, Wang F, Zhang H, Yu D, Wang J, Jin K, Yu W, Liu Y, Sun B. High preoperative serum globulin in hepatocellular carcinoma is a risk factor for poor survival. J Cancer 2019; 10(15):3494-3500. doi:10.7150/jca.29499. Available from https://www.jcancer.org/v10p3494.htm

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Background: Serum globulin (GLB), albumin (ALB) and albumin/globulin ratio (AGR) have been reported as prognosis related factors for certain malignancies; however, the prognostic value of globulin (GLB) in hepatocellular carcinoma (HCC) has rarely been studied. This study was performed to evaluate whether GLB analysis could be applied for the prediction of the prognosis of patients received liver resection.

Methods: A training cohort study involving 210 HCC patients undergoing curative liver resection between January 2007 and December 2012, and a validation cohort involving 100 HCC patients contemporaneously undergoing curative liver resection in another set were recruited. The survival curves were graphed and log-rank test was performed to analyze the differences between the curves. The cutoff value was selected by X-title program.

Results: Univariate and multivariate analysis indicated that high serum GLB level is a risk factor for poor cancer-specific survival (CSS) (P < 0.05). Conversely, high ALB level is a prediction for favor CSS (P = 0.010).

Conclusions: We identified the preoperative high GLB level as a prognostic risk factor for patients after treatment of liver cancer resection. This easily obtained variable may act as an available clinical biomarker to predict the prognosis of such patients.

Keywords: HCC, globulin, albumin, survival