1
|
Siwo GH, Singal AG, Waljee AK. Pan-cancer molecular signatures connecting aspartate transaminase (AST) to cancer prognosis, metabolic and immune signatures. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.01.582939. [PMID: 38496547 PMCID: PMC10942358 DOI: 10.1101/2024.03.01.582939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Background Serum aspartate transaminase (sAST) level is used routinely in conjunction with other clinical assays to assess liver health and disease. Increasing evidence suggests that sAST is associated with all-cause mortality and has prognostic value in several cancers, including gastrointestinal and urothelial cancers. Here, we undertake a systems approach to unravel molecular connections between AST and cancer prognosis, metabolism, and immune signatures at the transcriptomic and proteomic levels. Methods We mined public gene expression data across multiple normal and cancerous tissues using the Genotype Tissue Expression (GTEX) resource and The Cancer Genome Atlas (TCGA) to assess the expression of genes encoding AST isoenzymes (GOT1 and GOT2) and their association with disease prognosis and immune infiltration signatures across multiple tumors. We examined the associations between AST and previously reported pan-cancer molecular subtypes characterized by distinct metabolic and immune signatures. We analyzed human protein-protein interaction networks for interactions between GOT1 and GOT2 with cancer-associated proteins. Using public databases and protein-protein interaction networks, we determined whether the subset of proteins that interact with AST (GOT1 and GOT2 interactomes) are enriched with proteins associated with specific diseases, miRNAs and transcription factors. Results We show that AST transcript isoforms (GOT1 and GOT2) are expressed across a wide range of normal tissues. AST isoforms are upregulated in tumors of the breast, lung, uterus, and thymus relative to normal tissues but downregulated in tumors of the liver, colon, brain, kidney and skeletal sarcomas. At the proteomic level, we find that the expression of AST is associated with distinct pan-cancer molecular subtypes with an enrichment of specific metabolic and immune signatures. Based on human protein-protein interaction data, AST physically interacts with multiple proteins involved in tumor initiation, suppression, progression, and treatment. We find enrichments in the AST interactomes for proteins associated with liver and lung cancer and dermatologic diseases. At the regulatory level, the GOT1 interactome is enriched with the targets of cancer-associated miRNAs, specifically mir34a - a promising cancer therapeutic, while the GOT2 interactome is enriched with proteins that interact with cancer-associated transcription factors. Conclusions Our findings suggest that perturbations in the levels of AST within specific tissues reflect pathophysiological changes beyond tissue damage and have implications for cancer metabolism, immune infiltration, prognosis, and treatment personalization.
Collapse
Affiliation(s)
| | - Amit G. Singal
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas TX
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
| | - Akbar K. Waljee
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas TX
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
2
|
Parashar P, Das MK, Tripathi P, Kataria T, Gupta D, Sarin D, Hazari PP, Tandon V. DMA, a Small Molecule, Increases Median Survival and Reduces Radiation-Induced Xerostomia via the Activation of the ERK1/2 Pathway in Oral Squamous Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14194908. [PMID: 36230831 PMCID: PMC9562201 DOI: 10.3390/cancers14194908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 06/24/2022] [Accepted: 07/09/2022] [Indexed: 11/16/2022] Open
Abstract
Survival, recurrence, and xerostomia are considerable problems in the treatment of oral squamous carcinoma patients. In this study, we investigated the role of DMA (5-(4-methylpiperazin-1-yl)-2-[2′-(3,4-dimethoxyphenyl)5″benzimidazoyl]benzimidazole) as a salivary gland cytoprotectant in a patient-derived xenograft mouse model. A significant increase in saliva secretion was observed in the DMA-treated xenograft compared to radiation alone. Repeated doses of DMA with a high dose of radiation showed a synergistic effect on mice survival and reduced tumor growth. The mean survival rate of tumor-bearing mice was significantly enhanced. The increased number of Ki-67-stained cells in the spleen, intestine, and lungs compared to the tumor suggests DMA ablates the tumor but protects other organs. The expression of aquaporin-5 was restored in tumor-bearing mice injected with DMA before irradiation. The reduced expression of αvβ3 integrin and CD44 in DMA alone and DMA with radiation-treated mice suggests a reduced migration of cells and stemness of cancer cells. DMA along with radiation treatment results in the activation of the Ras/Raf/MEK/ERK pathway in the tumor, leading to apoptosis through caspase upregulation. In conclusion, DMA has strong potential for use as an adjuvant in radiotherapy in OSCC patients.
Collapse
Affiliation(s)
- Palak Parashar
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India
| | - Monoj Kumar Das
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India
| | - Pragya Tripathi
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India
| | - Tejinder Kataria
- Division of Radiation Oncology, Medanta―The Medicity, Gurgaon 122001, India
| | - Deepak Gupta
- Division of Radiation Oncology, Medanta―The Medicity, Gurgaon 122001, India
| | - Deepak Sarin
- Head and Neck OncoSurgery, Medanta―The Medicity, Gurgaon 122001, India
| | - Puja Panwar Hazari
- Defence Research and Development Organization, Institute of Nuclear Medicine and Allied Sciences, Delhi 110054, India
| | - Vibha Tandon
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India
- Correspondence: ; Tel.: +91-11-26742181
| |
Collapse
|
3
|
Shen Y, Huang Q, Zhang Y, Hsueh CY, Zhou L. A novel signature derived from metabolism-related genes GPT and SMS to predict prognosis of laryngeal squamous cell carcinoma. Cancer Cell Int 2022; 22:226. [PMID: 35804447 PMCID: PMC9270735 DOI: 10.1186/s12935-022-02647-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/28/2022] [Indexed: 12/30/2022] Open
Abstract
Background A growing body of evidence has suggested the involvement of metabolism in the occurrence and development of tumors. But the link between metabolism and laryngeal squamous cell carcinoma (LSCC) has rarely been reported. This study seeks to understand and explain the role of metabolic biomarkers in predicting the prognosis of LSCC. Methods We identified the differentially expressed metabolism-related genes (MRGs) through RNA-seq data of The Cancer Genome Atlas (TCGA) and Gene set enrichment analysis (GSEA). After the screening of protein–protein interaction (PPI), hub MRGs were analyzed by least absolute shrinkage and selection operator (LASSO) and Cox regression analyses to construct a prognostic signature. Kaplan–Meier survival analysis and the receiver operating characteristic (ROC) was applied to verify the effectiveness of the prognostic signature in four cohorts (TCGA cohort, GSE27020 cohort, TCGA-sub1 cohort and TCGA-sub2 cohort). The expressions of the hub MRGs in LSCC cell lines and clinical samples were verified by quantitative reverse transcriptase PCR (qRT-PCR). The immunofluorescence staining of the tissue microarray (TMA) was carried out to further verify the reliability and validity of the prognostic signature. Cox regression analysis was then used to screen for independent prognostic factors of LSCC and a nomogram was constructed based on the results. Results Among the 180 differentially expressed MRGs, 14 prognostic MRGs were identified. A prognostic signature based on two MRGs (GPT and SMS) was then constructed and verified via internal and external validation cohorts. Compared to the adjacent normal tissues, SMS expression was higher while GPT expression was lower in LSCC tissues, indicating poorer outcomes. The prognostic signature was proven as an independent risk factor for LSCC in both internal and external validation cohorts. A nomogram based on these results was developed for clinical application. Conclusions Differentially expressed MRGs were found and proven to be related to the prognosis of LSCC. We constructed a novel prognostic signature based on MRGs in LSCC for the first time and verified it via different cohorts from both databases and clinical samples. A nomogram based on this prognostic signature was developed. Supplementary Information The online version contains supplementary material available at 10.1186/s12935-022-02647-2.
Collapse
Affiliation(s)
- Yujie Shen
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Qiang Huang
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Yifan Zhang
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Chi-Yao Hsueh
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
| | - Liang Zhou
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
| |
Collapse
|
4
|
Takenaka Y, Oya R, Takemoto N, Inohara H. Neutrophil-to-lymphocyte ratio as a prognostic marker for head and neck squamous cell carcinoma treated with immune checkpoint inhibitors: Meta-analysis. Head Neck 2022; 44:1237-1245. [PMID: 35146824 DOI: 10.1002/hed.26997] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/21/2022] [Accepted: 02/01/2022] [Indexed: 02/06/2023] Open
Abstract
We investigated the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR) in patients with head and neck squamous cell carcinoma (HNSCC) treated with immune checkpoint inhibitors (ICIs). We systematically searched electronic databases and identified articles reporting an association between NLR and treatment results in patients with HNSCC treated with ICIs. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) and odds ratios (ORs) for response and disease control were extracted. Pooled HRs and ORs were estimated using random-effects models. Fourteen studies involving 929 patients were included. A higher NLR was associated with poor OS (HR 2.03, 95% confidence interval [CI] 1.50-2.74), PFS (HR 2.15, 95% CI 1.44-3.21), response (OR 0.49, 95% CI 0.26-0.93), and disease control (OR 0.30, 95% CI 0.12-0.74). The NLR predicts treatment results with ICIs in patients with HNSCC.
Collapse
Affiliation(s)
- Yukinori Takenaka
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryohei Oya
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norihiko Takemoto
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
5
|
Sansa A, Venegas MDP, Valero C, Pardo L, Avilés-Jurado FX, Terra X, Quer M, León X. The aspartate aminotransaminase/alanine aminotransaminase (De Ritis) ratio predicts sensitivity to radiotherapy in head and neck carcinoma patients. Head Neck 2021; 43:2091-2100. [PMID: 33675096 DOI: 10.1002/hed.26673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/27/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study is to evaluate the relationship between the aspartate aminotransaminase (AST) and alanine aminotransaminase (ALT) ratio and local disease control in patients with head and neck squamous cell carcinomas (HNSCC) treated with radiotherapy/chemoradiotherapy. METHODS We calculated the pre-treatment AST/ALT ratio in 670 patients with HNSCC treated with radiotherapy (n = 309, 46.1%) or chemoradiotherapy (n = 361, 53.9%). RESULTS Five-year local recurrence-free survival for patients with a low AST/ALT ratio value (n = 529, 79.0%) was 75.0% (95% CI: 71.1-78.9), and for patients with a high value (n = 141, 21.0%) it was 53.4% (CI 95: 44.4-62.4) (p = 0.0001). In a multivariable analysis, patients with a high ratio had nearly twice the risk of having a local tumor recurrence (HR 1.97, 95% CI 1.42-2.75, p = 0.0001). CONCLUSION The AST/ALT ratio was independently associated with the risk of local recurrence in patients with HNSCC treated with radiotherapy or chemoradiotherapy.
Collapse
Affiliation(s)
- Aina Sansa
- Department of Otorhinolaryngology, Hospital Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - María Del Prado Venegas
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Valero
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Pardo
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesc-Xavier Avilés-Jurado
- Department of Otorhinolaryngology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (CIBERDEM), Spain
| | - Ximena Terra
- MoBioFood Research Group, Biochemistry and Biotechnology Department, Universitat Rovira i Virgili, Tarragona, Spain
| | - Miquel Quer
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Xavier León
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| |
Collapse
|
6
|
The AST/ALT (De Ritis) Ratio Predicts Survival in Patients with Oral and Oropharyngeal Cancer. Diagnostics (Basel) 2020; 10:diagnostics10110973. [PMID: 33228184 PMCID: PMC7699507 DOI: 10.3390/diagnostics10110973] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 01/04/2023] Open
Abstract
Aminotransaminases, including aspartate aminotransaminase (AST) and alanine aminotransaminase (ALT), are strongly involved in cancer cell metabolism and have been associated with prognosis in different types of cancer. The purpose of the present study was to evaluate the prognostic significance of the pre-treatment AST/ALT ratio in a large European cohort of patients with oral and oropharyngeal squamous cell cancer (OOSCC). Data from 515 patients treated for OOSCC at a tertiary academic center from 2000–2017 were retrospectively analyzed. Levels of AST and ALT were measured prior to the start of treatment. Uni- and multivariate Cox regression analyses were applied to evaluate the prognostic value of the AST/ALT ratio for cancer-specific survival (CSS) and overall survival (OS), survival rates were calculated. Univariate analyses showed a significant association of the AST/ALT ratio with CSS (hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.38–2.12; p < 0.001) and OS (HR 1.69, 95% CI 1.41–2.02; p < 0.001). In multivariate analysis, the AST/ALT ratio remained an independent prognostic factor for CSS and OS (HR 1.45, 95% CI 1.12–1.88, p = 0.005 and HR 1.42, 95% CI 1.14–1.77, p = 0.002). Applying receiver operating characteristics (ROC) curve analysis, the optimal cut-off level for the AST/ALT ratio was 1.44, respectively. In multivariate analysis, an AST/ALT ratio > 1.44 was an independent prognostic factor for poor CSS and OS (HR 1.64, 95% CI 1.10–2.43, p = 0.014 and HR 1.55, 95% CI 1.12–2.15; p = 0.008). We conclude that the AST/ALT ratio is a prognostic marker for survival in OOSCC patients and could contribute to a better risk stratification and improved oncological therapy decisions.
Collapse
|
7
|
Su S, Liu L, Li C, Zhang J, Li S. Prognostic Role of Pretreatment De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase Ratio) in Urological Cancers: A Systematic Review and Meta-Analysis. Front Oncol 2020; 10:1650. [PMID: 33014827 PMCID: PMC7498547 DOI: 10.3389/fonc.2020.01650] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/27/2020] [Indexed: 02/04/2023] Open
Abstract
Background: To examine the potential prognostic significance of pretreatment De Ritis ratio (aspartate transaminase/alanine transaminase ratio) in urological cancers, including upper tract urothelial cancer (UTUC), renal cell carcinoma (RCC), prostate cancer (PCa), bladder cancer (BCa). Methods: Potential literatures were searched with PubMed, Embase, Cochrane Library, and Web of Science in December 2019. Merged hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate the associations. Results: Totally, 15 studies with 8,565 patients were included. Merged results showed that an elevated pretreatment De Ritis ratio was correlated with poorer OS (HR 1.80, 95% CI 1.61–2.01), CSS (HR 2.15, 95% CI 1.80–2.56), PFS (HR 1.57, 95% CI 1.34–1.85), BRFS (HR 1.67, 95% CI 1.11–2.53) for urological cancers. Subgroup analyses by cancer type for OS found that De Ritis ratio can be a predictor in UTUC (HR 1.91, 95% CI 1.57–2.33), RCC (HR 1.74, 95% CI 1.47–2.07), and BCa (HR 1.80, 95% CI 1.43–2.27). Similar results could be found for CSS (UTUC: HR 2.46, 95% CI 1.93–3.13; RCC: HR 1.90, 95% CI 1.46-2.47; BCa: HR 2.71, 95% CI 1.39-5.31) and PFS (UTUC: HR 1.59, 95% CI 1.15–2.20; RCC: HR 1.52, 95% CI 1.26–1.83; BCa: HR 1.79, 95% CI 1.18–2.72). There was no publication bias among these included studies. Conclusions: Pretreatment De Ritis ratio was a significant predictor for OS, CSS, PFS and BRFS in urological cancers, indicating that it could be a promising prognostic factor during clinical practice.
Collapse
Affiliation(s)
- Shiqiang Su
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Lizhe Liu
- Department of Pathophysiology, Hebei Medical University, Shijiazhuang, China
| | - Chao Li
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Jin Zhang
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Shen Li
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
| |
Collapse
|
8
|
Riedl JM, Posch F, Prager G, Eisterer W, Oehler L, Sliwa T, Wilthoner K, Petzer A, Pichler P, Hubmann E, Winder T, Burgstaller S, Korger M, Andel J, Greil R, Neumann HJ, Pecherstorfer M, Philipp-Abbrederis K, Djanani A, Gruenberger B, Laengle F, Wöll E, Gerger A. The AST/ALT (De Ritis) ratio predicts clinical outcome in patients with pancreatic cancer treated with first-line nab-paclitaxel and gemcitabine: post hoc analysis of an Austrian multicenter, noninterventional study. Ther Adv Med Oncol 2020; 12:1758835919900872. [PMID: 32313566 PMCID: PMC7153180 DOI: 10.1177/1758835919900872] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/19/2019] [Indexed: 12/12/2022] Open
Abstract
Background: The pretreatment De Ritis ratio [aspartate transaminase (AST)/alanine transaminase (ALT)] has been shown to be an adverse prognostic marker in various cancer entities. However, its relevance to advanced pancreatic ductal adenocarcinoma (PDAC) has not yet been studied. In the present study we investigated the AST/ALT ratio as a possible predictor of treatment response and disease outcome in patients with advanced PDAC treated with first-line gemcitabine/nab-paclitaxel. Methods: A post hoc analysis of a prospective, multicenter, noninterventional study was performed. A total of 202 patients with advanced PDAC treated with first-line gemcitabine/nab-paclitaxel for whom the AST/ALT ratio was measured were included in this analysis. Results: Median and 1-year progression-free survival estimates were 4.8 months and 5.1%, respectively in patients with an AST/ALT ratio above the 75th percentile of its distribution, and 6.0 months and 18.7%, respectively in patients with an AST/ALT ratio less than or equal to this cutoff, respectively (log-rank p = 0.004). In univariable Cox regression, a doubling of the AST/ALT ratio was associated with a 1.4-fold higher relative risk of progression or death [hazard ratio = 1.38, 95% confidence interval (CI): 1.06–1.80, p = 0.017]. The prognostic association was also found in multivariable analysis adjusting for Eastern Cooperative Oncology Group performance status and lung metastases (hazard ratio per AST/ALT ratio doubling = 1.32, 95% CI: 1.00–1.75, p = 0.047). In treatment response analysis, a doubling of the AST/ALT ratio was associated with a 0.5-fold lower odds of objective response (odds ratio = 0.54, 95% CI: 0.31–0.94, p = 0.020). Conclusions: The pretreatment serum AST/ALT ratio predicts poor disease outcome and response rate in patients with advanced PDAC treated with gemcitabine/nab-paclitaxel and might represent a novel and inexpensive marker for individual risk assessment in the treatment of pancreatic cancer.
Collapse
Affiliation(s)
- Jakob Michael Riedl
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Florian Posch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Gerald Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Eisterer
- Department of Internal Medicine, Klinikum Klagenfurt am Wörthersee, Feschnigstraße Sarcoma Platform Austria, Austria
| | - Leopold Oehler
- Department of Medicine, St. Joseph Hospital, Vienna, Vienna, Austria
| | - Thamer Sliwa
- Third Medical Department, Hanusch Hospital, Vienna, Austria
| | | | - Andreas Petzer
- Department of Internal Medicine I, Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz-Elisabethinen, Linz, Austria
| | - Petra Pichler
- Universitätsklinikum St. Pölten, Sankt Pölten, Austria
| | - Eva Hubmann
- Department of Internal Medicine 1, Hospital of the Brothers of St. John of God, Graz, Austria
| | - Thomas Winder
- Division of Oncology, Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Sonja Burgstaller
- Abteilung für Innere Medizin IV, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Markus Korger
- Krankenhaus der barmherzigen Brüder, Eisenstadt, Austria
| | | | - Richard Greil
- IIIrd Medical Department, Paracelsus Medical University Salzburg, Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Salzburg, Austria
| | | | - Martin Pecherstorfer
- Department of Internal Medicine 2, University Hospital Krems, Karl Landsteiner Private University of Health Sciences, Krems, Austria
| | - Kathrin Philipp-Abbrederis
- Department of Internal Medicine I, Gastroenterology, Hepatology, Metabolism & Endocrinology, Medical University Innsbruck, Innsbruck, Austria
| | - Angela Djanani
- Department of Internal Medicine I, Gastroenterology, Hepatology, Metabolism & Endocrinology, Medical University Innsbruck, Innsbruck, Austria
| | - Birgit Gruenberger
- Department of Surgery, Landesklinikum Wr. Neustadt, Wr. Neustadt, Austria
| | - Friedrich Laengle
- Department of Surgery, Landesklinikum Wr. Neustadt, Wr. Neustadt, Austria
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital Zams, Sanatoriumstrasse, Zams, Austria
| | - Armin Gerger
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz, 8036, Austria
| |
Collapse
|
9
|
Hu X, Yang WX, Wang Y, Shao YX, Xiong SC, Li X. The prognostic value of De Ritis (AST/ALT) ratio in patients after surgery for urothelial carcinoma: a systematic review and meta-analysis. Cancer Cell Int 2020; 20:39. [PMID: 32042266 PMCID: PMC6998332 DOI: 10.1186/s12935-020-1125-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 01/25/2020] [Indexed: 02/08/2023] Open
Abstract
Background Recently, the De Ritis (AST/ALT) ratio has been considered as a prognostic biomarker for various malignancies. We conducted this systematic review and meta-analysis to explore the prognostic value of preoperative De Ritis ratio in patients after surgery for urothelial carcinoma. Methods We searched the online database Embase, PubMed and Cochrane Library up to October 2019. The hazard ratio (HR) and 95% confidence interval (CI) were extracted from the studies. Results A total of 8 studies incorporating 3949 patients were included in the quantitative synthesis. We observed that elevated preoperative De Ritis ratio is associated with inferior OS (HR = 1.97; 95% CI 1.70–2.28; P < 0.001), CSS (HR = 2.40; 95% CI 2.02–2.86; P < 0.001), RFS (HR = 1.31; 95% CI 1.11–1.54; P = 0.001), PFS (HR = 2.07; 95% CI 1.68–2.56; P < 0.001) and MFS (HR = 2.39; 95% CI 1.16–4.91; P = 0.018). Stratified by diseases, the elevated De Ritis ratio also served as an unfavorable factor. Conclusion The elevated preoperative De Ritis ratio is an unfavorable factor for patients with urothelial carcinoma. In patients with BC and UTUC, the elevated preoperative De Ritis ratio is also associated with poor prognosis. But De Ritis ratio must be validated in large, independent cohorts before it can be applied widely.
Collapse
Affiliation(s)
- Xu Hu
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Wei-Xiao Yang
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Yan Wang
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Yan-Xiang Shao
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - San-Chao Xiong
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Xiang Li
- 2Department of Urology, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Street, Chengdu, 610041 People's Republic of China
| |
Collapse
|
10
|
Wu J, Li S, Wang Y, Hu L. Pretreatment Aspartate Aminotransferase-to-Alanine Aminotransferase (De Ritis) Ratio Predicts the Prognosis of Nonmetastatic Nasopharyngeal Carcinoma. Onco Targets Ther 2019; 12:10077-10087. [PMID: 31819502 PMCID: PMC6878916 DOI: 10.2147/ott.s232563] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/15/2019] [Indexed: 12/24/2022] Open
Abstract
Background The pretreatment aspartate aminotransferase-to-alanine aminotransferase (De Ritis) ratio is reportedly valuable in prognosis prediction of various malignancies. However, its value in the prognosis of nasopharyngeal carcinoma (NPC) has not yet been reported. This study aimed to evaluate the effect of the De Ritis ratio on the survival outcomes of patients with nonmetastatic NPC. Methods We retrospectively reviewed the medical data of 1023 patients with nonmetastatic NPC admitted between 2009 and 2013 at a single center. The Fine and Gray competing risk regression model was used to analyze the associations between the De Ritis ratio and the survival outcomes of cancer-specific survival (CSS) and progression-free survival (PFS) by using the subdistribution hazard ratio (SHR) and 95% confidence interval (CI) as size effects. The Cox proportional hazard model was used to evaluate the correlation between the De Ritis ratio and overall survival (OS) by using hazard ratio (HR) and 95% CI as size effects. Results Patients were divided into two groups in accordance with the pretreatment De Ritis ratio by using an optimal cutoff value of 1.65. Compared with the patients with low De Ritis ratio (< 1.65), those with elevated De Ritis ratio (≥ 1.65) had poorer prognosis with regard to CSS, PFS, and OS. Notably, multivariate analyses showed that high De Ritis ratio was independently associated with poor CSS (SHR = 1.64, 95% CI: 1.25–2.16), PFS (SHR = 1.69, 95% CI: 1.30–2.19), and OS (HR = 1.81, 95% CI: 1.39–2.40). Conclusion Pretreatment De Ritis ratio can be an independent prognostic predictor for patients with nonmetastatic NPC.
Collapse
Affiliation(s)
- Jiayuan Wu
- Department of Clinical Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Shasha Li
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Yufeng Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Liren Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| |
Collapse
|
11
|
Fukui S, Miyake M, Iida K, Onishi K, Hori S, Morizawa Y, Kagebayashi Y, Fujimoto K. The Preoperative Predictive Factors for Pathological T3a Upstaging of Clinical T1 Renal Cell Carcinoma. Diagnostics (Basel) 2019; 9:diagnostics9030076. [PMID: 31311108 PMCID: PMC6787604 DOI: 10.3390/diagnostics9030076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/13/2019] [Accepted: 07/14/2019] [Indexed: 12/15/2022] Open
Abstract
We aimed to determine the oncological outcomes of patients with clinical T1 renal cell carcinoma (RCC) upstaged to pathological T3a and to identify the preoperative predictive factors for upstaging. We retrospectively reviewed 272 patients with clinical T1 RCC who underwent surgical treatment. Thirty-three patients (12%) were upstaged to pathological T3a. These patients had a significantly larger tumor size on computed tomography (p < 0.0001), a higher aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (p = 0.037), and an elevated c-reactive protein (CRP) level (p = 0.014) preoperatively compared with those with pathological T1 RCC. On multivariate analysis, tumor diameter was the only significant preoperative predictive factor for upstaging [hazard ratio (HR), 3.61; 95% confidence interval (CI), 1.32-9.84; p = 0.01]. The AST/ALT ratio tended to be a preoperative predictive factor for upstaging, although it was not significant (HR, 2.14; 95% CI, 0.97-4.73; p = 0.06). Pathological T3a upstaging occurred in 25% of those with a tumor diameter ≥30 mm and a preoperative AST/ALT ratio ≥1.1. There was a significant correlation between pathological T3a upstaging and the number of preoperative risk factors (p = 0.0002). The preoperative tumor diameter and serum AST/ALT ratio can be predictive factors for pathological T3a upstaging in patients with clinical T1 RCC.
Collapse
Affiliation(s)
- Shinji Fukui
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan.
| | - Makito Miyake
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Kota Iida
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Kenta Onishi
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Yoriaki Kagebayashi
- Department of Urology, Nara Prefecture General Medical Center, 897-5, Shichijo-nishi machi 2 chome, Nara, Nara 630-8581, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| |
Collapse
|
12
|
Wu J, Chen L, Wang Y, Tan W, Huang Z. Prognostic value of aspartate transaminase to alanine transaminase (De Ritis) ratio in solid tumors: a pooled analysis of 9,400 patients. Onco Targets Ther 2019; 12:5201-5213. [PMID: 31308692 PMCID: PMC6612963 DOI: 10.2147/ott.s204403] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/18/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Numerous studies have reported the association between pretreatment serum aspartate transaminase to alanine transaminase (AST/ALT) ratio and prognosis in multiple cancers. However, the results remain controversial and no consensus has been reached. Thus, we conducted this meta-analysis to quantitatively assess the prognostic value of pretreatment AST/ALT ratio in solid tumors. METHODS A systematic literature search was conducted by using PubMed, EMBASE, Web of Science, Cochrane Library, and Wanfang databases, as well as several trial registry platforms, including ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and Chinese Clinical Trial Registry, up to April 5, 2019. HR and 95% CI for overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were calculated to estimate the effect size. RESULTS A total of 18 studies with 9,400 patients were included. Overall, a high level of pretreatment AST/ALT ratio was significantly associated with worse OS (pooled HR=1.70, 95% CI=1.38-2.09). The statistical significance was observed in all cancer types, including renal cell carcinoma (pooled HR=1.64, 95% CI=1.30-2.05), liver cancer (pooled HR=1.16, 95% CI=1.04-1.29), urinary tract urothelial carcinoma (pooled HR=1.96, 95% CI=1.53-2.51), bladder cancer (pooled HR =2.66, 95% CI=1.69-4.20), and other cancers (pooled HR=1.44, 95% CI=1.18-1.76). Moreover, an increased level of serum AST/ALT ratio predicted unfavorable CSS (pooled HR=2.07, 95% CI=1.74-2.46) and RFS (pooled HR=1.51, 95% CI=1.15-1.99). CONCLUSION Elevated level of serum AST/ALT ratio before treatment is significantly associated with poor clinical outcomes of OS, CSS, and RFS in patients with solid tumors. Pretreatment AST/ALT ratio can serve as a useful prognostic predictor for malignant patients.
Collapse
Affiliation(s)
- Jiayuan Wu
- Clinical Research Center, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
| | - Lin Chen
- Department of Cardiac Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
| | - Yufeng Wang
- School of Public Health, Guangdong Medical University, Zhanjiang524023, Guangdong Province, People’s Republic of China
| | - Wenkai Tan
- Department of Gastroenterology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
| | - Zhe Huang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
| |
Collapse
|
13
|
Li Y, Fang D, Bao Z, He A, Guan B, He S, Zhan Y, Gong Y, Li X, Zhou L. High aspartate transaminase/alanine transaminase ratio predicts poor prognosis in patients with localized upper tract urothelial cancer: a propensity score-matched study in a large Chinese center. Onco Targets Ther 2019; 12:2635-2648. [PMID: 31114222 PMCID: PMC6489587 DOI: 10.2147/ott.s193771] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/17/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the prognostic value of the aspartate transaminase/alanine transaminase (AST/ALT) ratio in a large Chinese cohort surgically treated for localized upper tract urothelial carcinoma (UTUC) using propensity score matching (PSM) analysis. Methods: Data of 908 consecutive patients with localized UTUC who underwent radical nephroureterectomy (RNU) were retrospectively evaluated. The endpoints of prognosis were progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) after RNU. We compared these endpoints according to the AST/ALT ratio before and after 1:1 PSM. The independent predictors for PFS, CSS and OS were also analyzed. Results: A high AST/ALT ratio was correlated with unfavorable factors, including elderly age, female gender, history of coronary disease, alcohol and tobacco consumption, lower body mass index, and larger tumor volume. Before PSM, the Kaplan–Meier curves showed significantly poorer survival outcomes in PFS, CSS, and OS (all P<0.001) for patients with high AST/ALT ratios. After PSM, the high AST/ALT ratio group also had significantly inferior survival outcomes in terms of PFS, OS and CSS (all P<0.001). Furthermore, multivariate analyses revealed that the AST/ALT ratio was an independent predictor for PFS, CSS and OS before PSM (PFS hazard ratio [HR] 1.454, P=0.001; CSS HR 2.577, P<0.001; OS HR 1.925, P<0.001) and after PSM (PFS HR 1.711, P<0.001; CSS HR 2.588, P<0.001; OS HR 1.957, P<0.001). Conclusion: The preoperative AST/ALT ratio can be a convenient and useful prognostic biomarker for patients with localized UTUC.
Collapse
Affiliation(s)
- Yifan Li
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Dong Fang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Zhengqing Bao
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Anbang He
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Bao Guan
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Shiming He
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Yonghao Zhan
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Yanqing Gong
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| |
Collapse
|
14
|
Takenaka Y, Oya R, Kitamiura T, Ashida N, Shimizu K, Takemura K, Yamamoto Y, Uno A. Platelet count and platelet-lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta-analysis. Head Neck 2018; 40:2714-2723. [PMID: 30102821 DOI: 10.1002/hed.25366] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/28/2018] [Accepted: 05/18/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thrombocytosis is associated with the prognosis of various types of cancer. The purpose of this study was to quantify the prognostic impact of platelet count and platelet-lymphocyte ratio (PLR) in head and neck squamous cell carcinoma (HNSCC). METHODS We systematically searched electronic databases and identified articles reporting an association between platelet count or PLR and HNSCC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) were extracted, and the pooled HRs were estimated using random effect models. RESULTS Eight studies that enrolled 4096 patients and 9 studies that enrolled 2327 patients were included in the platelet count and PLR analyses, respectively. A platelet count greater than the cutoff value was associated with poor OS (HR 1.81; 95% CI 1.16-2.82) and any PLR greater than the cutoff value was associated with poor OS (HR 1.64; 95% CI 1.13-2.37). CONCLUSION Elevated platelet count and PLR are associated with poor prognosis in patients with HNSCC.
Collapse
Affiliation(s)
- Yukinori Takenaka
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Ryohei Oya
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Takahiro Kitamiura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Naoki Ashida
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kotaro Shimizu
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kazuya Takemura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Atsuhiko Uno
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| |
Collapse
|
15
|
Canat L, Ataly HA, Agalarov S, Alkan I, Altunrende F. The effect of AST/ALT (De Ritis) ratio on survival and its relation to tumor histopathological variables in patients with localized renal cell carcinoma. Int Braz J Urol 2018; 44:288-295. [PMID: 29211398 PMCID: PMC6050548 DOI: 10.1590/s1677-5538.ibju.2017.0173] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 06/17/2017] [Indexed: 12/28/2022] Open
Abstract
Purpose To assess the relationship between De Ritis (aspartate aminotransaminase [AST]/Alanine aminotransaminase [ALT]) ratio and pathological variables and whether it is an independent prognostic factor. Materials and Methods We analyzed 298 consecutive patients who underwent radical or partial nephrectomy for non-metastatic renal cell carcinoma (RCC) between 2006 and 2015. The association between De Ritis ratio and pathological variables including tumor size, presence of renal vein invasion, vena cava invasion, renal capsule infiltration, Gerota fascia invasion, renal sinus involvement, renal pelvic invasion, angiolymphatic invasion, adrenal gland involvement, lymph node involvement, tumor necrosis, and Fuhrman's grade was tested. Multivariable Cox analysis was performed to evaluate the impact of this ratio on overall survival and cancer-specific survival. Results An increased preoperative De Ritis ratio was significantly associated with renal vein invasion, renal capsule infiltration and renal pelvis involvement (p<0.05) in non-metastatic RCC. On multivariate analysis we found that tumor size, Fuhrman grade and lymph node involvement were independent prognostic factors for cancer-specific survival. AST/ALT ratio had no influence on the risk of overall and cancer-specific survival. Conclusion An increased preoperative AST/ALT ratio had a significant association with renal vein invasion, renal capsule infiltration and renal pelvis involvement in patients with non-metastatic RCC. However, it does not appear to be an independent prognostic marker in non-metastatic RCC.
Collapse
Affiliation(s)
- Lütfi Canat
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Hasan Anil Ataly
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Samir Agalarov
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Ilter Alkan
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Fatih Altunrende
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
16
|
Takenaka Y, Oya R, Aoki K, Hamaguchi H, Takemura K, Nozawa M, Kitamura T, Yamamoto Y, Uno A. Pretreatment serum lactate dehydrogenase as a prognostic indicator for oral cavity squamous cell carcinoma. Acta Otolaryngol 2018; 138:433-436. [PMID: 29233054 DOI: 10.1080/00016489.2017.1398839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To examine whether lactate dehydrogenase (LDH) can predict the prognosis of oral cavity squamous cell carcinoma (OSCC) and to determine the optimal cut-off values for LDH. METHODS This retrospective study included 184 patients with OSCC, treated with surgery between 2006 and 2014. The association between LDH and T, N classification was investigated using the Mann-Whitney test. Cut-off values for LDH were determined with a recursive partitioning analysis (RPA). Survival rates were estimated using the Kaplan-Meier method. A Cox hazard model was used to assess the prognostic capability of LDH. RESULTS There was no association between LDH and T or N classification (p = .657, .619, respectively). RPA determined the cut-off values for LDH as 160 and 220 IU/L. The five year survival for low-, moderate-, and high-LDH groups were 87.7, 73.7, and 50.9%, respectively (p < .001). The hazard ratios (HRs) for death in moderate- and high-LDH groups were 2.92 (95%CI =1.02-12.30, p = .001) and 7.36 (95%CI =2.54-31.20, p < .001), respectively. The model including LDH-based stratification (Akaike's information criterion (AIC) = 516) was better than the model including clinical stage (AIC =528). CONCLUSION Pretreatment serum LDH is an independent prognostic factor for overall survival in patients with OSCC.
Collapse
Affiliation(s)
- Yukinori Takenaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Ryohei Oya
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kengo Aoki
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Hiroko Hamaguchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kazuya Takemura
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Masayuki Nozawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Takahiro Kitamura
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Atsuhiko Uno
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| |
Collapse
|
17
|
Wang H, Fang K, Zhang J, Jiang Y, Wang G, Zhang H, Chen T, Shi X, Li Y, Duan F, Liu J. The significance of De Ritis (aspartate transaminase/alanine transaminase) ratio in predicting pathological outcomes and prognosis in localized prostate cancer patients. Int Urol Nephrol 2017; 49:1391-1398. [PMID: 28550473 DOI: 10.1007/s11255-017-1618-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/12/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE To illustrate whether De Ritis (aspartate transaminase-AST/alanine transaminase-ALT) ratio is useful in risk stratification of localized prostate cancer and propose an easy predictive model for biochemical recurrence-free survival (BCRFS). METHODS In total, 438 patients who underwent radical prostatectomy were included in this study. Blood samples including AST and ALT were collected 1-7 days before surgery. An elevated AST and ALT value was defined as over 40 or 56 IU/L. RESULTS The median AST and ALT value was 18.5 (16-22) and 14 (11-18) IU/L. In total, 15 patients (3.4%) and 9 patients (2.1%) exhibited elevated AST value and ALT value. The median De Ritis ratio was 1.33 (1.11-1.60), and ROC curve indicated the best cutoff of 1.325 in predicting the occurrence of biochemical recurrence. Higher De Ritis ratio was found to be related to older age (p < 0.001), higher tumor stages (p < 0.001) and Gleason Score (p < 0.001), presence of seminal invasion (p < 0.001), positive surgical margin (p < 0.001) and lymph node metastasis (p = 0.003). Multivariate logistic regression confirmed that De Ritis ratio was an independent predictor for final Gleason Score (p < 0.001), and multivariate Cox regression demonstrated De Ritis ratio as an independent risk factor for BCRFS. A simple predictive model which incorporated De Ritis ratio, pathological tumor stage and final Gleason Score could help risk stratification for BCRFS. CONCLUSION Higher De Ritis ratio could be predictive for worse pathological outcomes and higher BCR in localized prostate cancer patients. A predictive model which incorporates De Ritis ratio, Gleason Score and pathological tumor stage could help risk stratification for BCRFS.
Collapse
Affiliation(s)
- Huitao Wang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Kewei Fang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Jinsong Zhang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Yongming Jiang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Guang Wang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Haiyan Zhang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Tao Chen
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Xin Shi
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Yuhang Li
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Fei Duan
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Jianhe Liu
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China.
| |
Collapse
|
18
|
Cho YH, Hwang JE, Chung HS, Kim MS, Hwang EC, Jung SI, Kang TW, Kwon DD, Choi SH, Kim HT, Kim TH, Kwon TG, Noh JH, Kim MK, Kim CS, Kang SG, Kang SH, Cheon J, Lee CH, Ku JY, Ha HK, Tae BS, Jeong CW, Ku JH, Kwak C, Kim HH. The De Ritis (aspartate transaminase/alanine transaminase) ratio as a predictor of oncological outcomes in patients after surgery for upper urinary tract urothelial carcinoma. Int Urol Nephrol 2017; 49:1383-1390. [PMID: 28484945 DOI: 10.1007/s11255-017-1613-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/02/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE Recently, several studies have shown that the De Ritis ratio (aspartate transaminase/alanine transaminase) can be a useful prognostic biomarker for certain types of malignant tumors. However, the prognostic value of the De Ritis ratio in patients with upper tract urothelial carcinoma remains largely unknown. The aim of the present study was to evaluate the prognostic significance of the De Ritis ratio in patients who had undergone radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma. METHODS In total, 1049 patients who underwent RNU at eight institutions from 2004 to 2015 were reviewed retrospectively. The De Ritis ratio and conventional clinicopathological parameters were analyzed. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Multivariate analysis was carried out using the Cox proportional hazards regression model. De Ritis ratio cutoff values were derived from receiver operating characteristic (ROC) curves. RESULTS ROC analysis showed the cutoff De Ritis ratio for overall death to be 1.6 (p = 0.002). The cancer-specific survival (CSS) and overall survival (OS) were significantly shorter for patients with a high De Ritis ratio (>1.6). Multivariate analysis revealed an independent relationship between an increased De Ritis ratio (>1.6) and shorter CSS (hazard ratio, HR 2.49, 95% confidence interval, CI 1.70-3.64; p = 0.001) and OS (HR 1.84, 95% CI 1.34-2.52; p = 0.001). CONCLUSION The De Ritis ratio can be a significant predictor of oncological outcomes in patients with upper urinary tract urothelial carcinoma after surgery.
Collapse
Affiliation(s)
- Yang Hyun Cho
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Jun Eul Hwang
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Myung Soo Kim
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea.
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Taek Won Kang
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Seock Hwan Choi
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Tae Kim
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae-Hwan Kim
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Joon Hwa Noh
- Department of Urology, Kwangju Christian Hospital, Gwangju, Korea
| | - Myung Ki Kim
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - Chul-Sung Kim
- Department of Urology, Chosun University School of Medicine, Gwangju, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Chan Ho Lee
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Ja Yoon Ku
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Hong Koo Ha
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Bum Sik Tae
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|