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. 2017 Aug 14;17(1):544.
doi: 10.1186/s12885-017-3523-y.

Prognostic value of pretreatment serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio and gamma glutamyltransferase (GGT) in patients with esophageal squamous cell carcinoma

Hao Huang  1 , Xue-Ping Wang  2 , Xiao-Hui Li  2 , Hao Chen  2 , Xin Zheng  2 , Jian-Hua Lin  2 , Ting Kang  2 , Lin Zhang  3   4 , Pei-Song Chen  5
Affiliations

Prognostic value of pretreatment serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio and gamma glutamyltransferase (GGT) in patients with esophageal squamous cell carcinoma

Hao Huang et al. BMC Cancer. .

Abstract

Background: The levels of liver function tests (LFTs) are often used to assess liver injury and non-liver disease-related mortality. In our study, the relationship between pretreatment serum LFTs and overall survival (OS) was evaluated in esophageal squamous cell carcinoma (ESCC) patients.

Methods: Our purpose was to investigate the prognostic value of the preoperative alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio and gamma glutamyltransferase (GGT) in ESCC patients. A retrospective study was performed in 447 patients with ESCC, and follow-up period was at least 60 months until death. The prognostic significance of serum LFTs were determined by univariate and multivariate Cox hazard models.

Results: LFTs including ALT, AST, LSR, GGT, TBA and LDH were analyzed. Serum LSR (HR: 0.592, 95% CI = 0.457-0.768, p < 0.001 and GGT (HR: 1.507, 95% CI = 1.163-1.953, p = 0.002) levels were indicated as significant predictors of OS. The 5-year OS among patients with higher LSR levels was longer compared with those patients with decreased LSR levels, not only in the whole cohort but also in the subgroups stratified by pathological stage (T1-T2 subgroup, T3-T4 subgroup, N0 subgroup and M0 subgroup). We also found that patients with a higher GGT might predict worse OS than patients with a normal GGT, not only in the whole cohort but also in the subgroups stratified by pathological stage (T3-T4 subgroup and N1-N2 subgroup).

Conclusions: Both increased levels of LSR and decreased levels of GGT might predict shorter overall survival in ESCC patients. Our findings suggest that serum LSR and GGT levels could be used as a key predictor of survival in patients with ESCC.

Keywords: Alanine aminotransferase/aspartate aminotransferase ratio; Esophageal squamous cell carcinoma; Gamma glutamyltransferase; Overall survival; Prognosis.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institute Research Ethics Committee of the Sun Yat-Sen University Cancer Center, Guangzhou, China. Each patients signed the informed consent.

Consent for publication

Not applicable.

Competing interests

The authors disclose no competing interests. There are no financial and non-financial competing interests (political, personal, religious, ideological, academic, intellectual, commercial or any other) to declare in relation to this.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The prognostic value of serum LSR in ESCC in whole cohort and different pathological stages. Kaplan-Meier survival curves indicating lower LSR level was significantly related to poor survival not only in whole ESCC patients (a) but also in the subgroups stratified by pathological stage [T1–T2 subgroup (b), T3–T4 subgroup (c), N0 subgroup (d) and M0 subgroup (f)]. The OS was not significantly different in the N1–N2 subgroup (1e) and M1 subgroup (g)
Fig. 2
Fig. 2
The prognostic value of serum GGT levels in ESCC in whole cohort and different pathological stages. Kaplan-Meier survival curves indicating higher GGT level was significantly related to shorter survival not only in whole ESCC patients (a) but also in the subgroups stratified by pathological stage [T3–T4 subgroup (c) and N1-N2 subgroup (e)]. The OS was not significantly different in the stage T1–T2 subgroup (b), N0 subgroup (d), M0 subgroup (f) and M1 subgroup (g)
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