Abstract: Objective To investigate the value of gamma-glutamyl transpeptidase to platelet ratio index (GPRI) in predicting acute liver function deterioration (ALFD) in patients with primary liver cancer after transarterial chemoembolization (TACE).Methods The clinical data of 141 primary liver cancer patients treated with TACE in our hospital from June 2015 to December 2019 were retrospectively analyzed. The patients were divided into ALFD group and control group. The t test and χ² test were used to compare the clinical data between 2 groups. The predictive value of Child-Pugh score and GPRI was assessed by receiver operating characteristic (ROC) curve. Results The Child-Pugh score and GPRI of ALFD group were significantly higher than those of control group. The area under the ROC curve (AUC) and cut-off value of Child-Pugh score were 0.774 and 6. The AUC of GPRI were 0.784 and 2.02. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Child-Pugh score were 58.8%, 88.8%, 60.6%, 87.0% and 80.8%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of GPRI were 73.5%, 78.5%, 52.1%, 90.3% and 77.9%, respectively. GPRI > 2.02 was risk factor for ALFD.Conclusion GPRI is valuable in predicting ALFD after TACE. It is safe to receive TACE when pre-operation GPRI ≤ 2.02, which is helpful for evaluating the risk of ALFD in Child-Pugh B patients.

Key words: Gamma-glutamyl transpeptidase to platelet ratio index, Hepatocellular carcinoma, Transarterial chemoembolization, Acute liver function deterioration