GPT and hepatocellular carcinoma: Interestingly, serum AST/ALT-ratio levels were previously described as a biomarker for hepatitis B viral activity in the liver and, consequently, a poor prognosis in patients with hepatocellular carcinoma (Poon et al., 2000) was identified, the De Ritis ratio was also related to a high mortality rate in multiple cancer models in other previous studies.