GPT and hepatocellular carcinoma: Other factors associated with reduced survival include higher AFP levels (P = 0.001), larger tumor size (P ≤ 0.001), higher Edmondson grade (P = 0.028), and the presence of microvascular invasion (P = 0.001), all of which suggest that the GGT/ALT ratio is correlated with the degree of HCC malignancy.