The Impact of Adenotonsillectomy on Sleep and Behavior of Children with Obstructive Sleep Apnea.

OBJECTIVE

To evaluate the association between serum gamma-glutamyl transferase (GGT) levels and liver metastasis in gallbladder carcinoma (GBC) and assess its potential as an adjunctive biomarker for staging and surgical planning.

MATERIALS AND

METHODS

This observational, cross-sectional study was conducted over 18 months at a tertiary care centre and included 109 histologically confirmed GBC patients. Biochemical parameters, including serum GGT, alkaline phosphatase (ALP), bilirubin fractions, and tumor markers (CEA, CA 19 - 9, CA 125), were analyzed. The association between GGT and clinicopathological variables was assessed using appropriate statistical methods, and the diagnostic performance of GGT was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Based on contrast-enhanced CT imaging, patients were categorized into two groups: those with liver metastasis (n = 50) and those without (n = 59). Serum GGT levels were significantly elevated in the liver metastasis group (130.00[59.50-340.25]U/L) compared to those without metastasis (73.00[33.00-168.00]U/L; p = 0.0034). GGT showed strong correlations with ALP (ρ = 0.68, p < 0.001), direct bilirubin, and total bilirubin. ROC analysis yielded an AUC of 0.666, with a GGT cutoff of 203 U/L showing 44.0% sensitivity and 81.4% specificity. Elevated GGT was also significantly associated with distant lymphadenopathy, unresectability, higher TNM stage, and poorly differentiated tumors.

CONCLUSION

GGT is a readily available, low-cost biomarker significantly associated with advanced disease in GBC and liver metastases. Its integration into preoperative assessment may enhance staging accuracy and guide surgical decision-making. Prospective validation in larger cohorts is warranted.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13193-026-02593-9.