The predictive role of preoperative serum glutamate dehydrogenase levels in microvascular invasion and hepatocellular carcinoma prognosis following liver transplantation-a single center retrospective study

• Published in: PeerJ (San Francisco, CA) Vol. 9; p. e12420
• Main Authors: Gong, Jinlong, Li, Yaxiong, Yu, Jia, Wang, Tielong, Duan, Jinliang, Hu, Anbin, He, Xiaoshun, Zhu, Xiaofeng
• Format: Journal Article
• Language: English
• Published: United States PeerJ. Ltd 03.11.2021; PeerJ, Inc; PeerJ Inc
• Subjects: Analysis; Angiogenesis; Antigens; Basiliximab; Biomarkers; Dehydrogenases; Development and progression; Enzymes; Ethics; Gastroenterology and Hepatology; Glutamate; Glutamate dehydrogenase; Glutamine; Hepatitis B; Hepatocellular carcinoma; Hepatoma; Liver; Liver cancer; Liver cirrhosis; Liver transplantation; Medical prognosis; Medical records; Metabolism; Microvascular invasion; Microvasculature; Oncology; Patients; Physiological aspects; Prognosis; Risk factors; Surgery and Surgical Specialties; Survival; Transplantation; Transplants & implants; Tumors; Variables; Hepatocellular carcinoma; glutamate dehydrogenase; Microvascular invasion; Liver transplantation
• ISSN: 2167-8359; 2167-8359
• DOI: 10.7717/peerj.12420

As a critical metabolic substrate, glutamine is not only involved in the progression of many cancers but is also related to angiogenesis. Glutamate dehydrogenase (GLDH), a key enzyme in glutamine metabolism, has been reported to regulate tumor proliferation; however, its relationship with microvascular invasion (MVI) is unclear. This study evaluated the ability of preoperative serum GLDH levels to predict MVI and the long-term survival of hepatocellular carcinoma (HCC) patients after liver transplantation (LT). HCC patients that underwent LT from January 2015 to May 2020 at the First Affiliated Hospital of Sun Yat-Sen University were enrolled in our retrospective analysis. Clinicopathological variables were extracted from medical records. A receiver operating characteristic curve was created to determine the optimal cut-off value of GLDH for MVI. Preoperative GLDH was significantly elevated in the MVI-positive group ( = 454.00, = 0.000). The optimal cut-off value of GLDH for MVI was 7.45 U/L, with an area under the curve of 0.747 (95% CI [0.639-0.856], = 0.000). The sensitivity was 79.3%, while the specificity was 64.5%. GLDH > 7.45 U/L ( = 0.023) and maximum diameter >5 cm ( = 0.001) were independent risk factors for the presence of MVI. Patients with GLDH > 7.45 U/L had significantly poorer overall survival ( = 0.001) and recurrence-free survival ( = 0.001) after LT than patients with GLDH ≤ 7.45 U/L. Similarly, patients with MVI were associated with poor survival ( = 0.000). Preoperative elevated serum GLDH levels predict MVI and poorer long-term survival for HCC after LT.