Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma

  • Authors:
    • Hiroki Nishikawa
    • Yukio Osaki
    • Hideyuki Komekado
    • Azusa Sakamoto
    • Sumio Saito
    • Norihiro Nishijima
    • Akihiro Nasu
    • Akira Arimoto
    • Ryuichi Kita
    • Toru Kimura
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  • Published online on: December 22, 2014     https://doi.org/10.3892/or.2014.3691
  • Pages: 1071-1078
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Abstract

We aimed to examine the relationship between the preoperative GSA index [uptake ratio of the liver to the liver plus heart at 15 min (LHL15) to uptake ratio of the heart at 15 min to that at 3 min (HH15) ratio] calculated from 99mTc‑labeled diethylene triamine pentaacetate-galactosyl human serum albumin (99mTc-GSA) scintigraphy and background liver fibrosis and to investigate whether the GSA index can be a useful predictor in hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) patients treated with surgical resection (SR). A total of 213 HCV-related HCC patients were analyzed. Receiver operating characteristic (ROC) curve analysis was performed for calculating the area under the ROC (AUROC) for nine noninvasive parameters including GSA index, indocyanine green retention at 15 min, aspartate aminotransferase (AST) to platelet ratio index, FIB-4 index, AST to alanine aminotransferase ratio, serum albumin, total bilirubin, platelet count and prothrombin time for cirrhosis. We also examined predictive factors associated with overall survival (OS) and recurrence-free survival (RFS) after SR in univariate and multivariate analyses. There were 153 males and 60 females with the mean age of 69.9 years. The median observation periods were 2.8 years. The mean maximum tumor size was 4.1 cm. HH15 ranged from 0.452 to 0.897. LHL15 ranged from 0.669 to 0.982. The mean value of the GSA index was 1.41. Among the nine parameters, the GSA index yielded the highest AUROC for cirrhosis with a level of 0.786 at an optimal cut-off value of 1.37 (sensitivity, 65.9%; specificity, 79.0%). In multivariate analyses, the GSA index was an independent predictor (P<0.001) linked to RFS and it had a marginal significance in terms of OS (P=0.074). In conclusion, the preoperative GSA index can be a useful predictor in HCV-related HCC patients treated with SR.
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March-2015
Volume 33 Issue 3

Print ISSN: 1021-335X
Online ISSN:1791-2431

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Spandidos Publications style
Nishikawa H, Osaki Y, Komekado H, Sakamoto A, Saito S, Nishijima N, Nasu A, Arimoto A, Kita R, Kimura T, Kimura T, et al: Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma. Oncol Rep 33: 1071-1078, 2015
APA
Nishikawa, H., Osaki, Y., Komekado, H., Sakamoto, A., Saito, S., Nishijima, N. ... Kimura, T. (2015). Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma. Oncology Reports, 33, 1071-1078. https://doi.org/10.3892/or.2014.3691
MLA
Nishikawa, H., Osaki, Y., Komekado, H., Sakamoto, A., Saito, S., Nishijima, N., Nasu, A., Arimoto, A., Kita, R., Kimura, T."Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma". Oncology Reports 33.3 (2015): 1071-1078.
Chicago
Nishikawa, H., Osaki, Y., Komekado, H., Sakamoto, A., Saito, S., Nishijima, N., Nasu, A., Arimoto, A., Kita, R., Kimura, T."Clinical implication of the preoperative GSA index in 99mTc-GSA scintigraphy in hepatitis C virus-related hepatocellular carcinoma". Oncology Reports 33, no. 3 (2015): 1071-1078. https://doi.org/10.3892/or.2014.3691