Pretherapeutic gamma-glutamyltransferase is an independent prognostic factor for patients with renal cell carcinoma.
Pretherapeutic gamma-glutamyltransferase is an independent prognostic factor for patients with renal cell carcinoma.
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DOI：
10.1038/bjc.2014.450
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发表时间：
2014-10-14
影响因子：
8.8
通讯作者：
Klatte, T.
中科院分区：
文献类型：
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作者：
Hofbauer, S. L.;Stangl, K. I.;de Martino, M.;Lucca, I.;Haitel, A.;Shariat, S. F.;Klatte, T.
关键词：
γ -谷氨酰转移酶（GGT）调节细胞凋亡平衡，促进肿瘤进展和侵袭。治疗前较高的血清GGT水平与各种恶性肿瘤的预后较差相关，但没有关于肾细胞癌（RCC）的数据。回顾性评估1998年至2013年在同一家机构接受肾切除术的921例连续RCC患者的治疗前血清GGT水平和临床病理参数。谷氨酰转移酶作为连续变量和分类变量进行分析。采用Cox比例风险模型评估与rcc特异性生存率的关系。歧视用c指数来衡量。采用决策曲线分析评价临床净收益。术后中位随访45个月。治疗前血清GGT水平中位数为25 μ l−1。γ -谷氨酰转移酶水平随着T （P<0.001）、N （P=0.006）和M分期（P<0.001）、更高的分级（P<0.001）和肿瘤坏死（P<0.001）的进展而升高。GGT升高10 μ l−1与RCC死亡风险升高4%相关（HR 1.04， P<0.001）。基于递归分区生存树分析，我们定义了GGT的四种预后类别：正常低（<17.5 U l−1），正常高（17.5至<34.5 U l−1），升高（34.5至<181.5 U l−1）和高度升高（大于或等于181.5 U l−1）。在调整标准特征影响的多变量分析中，连续编码和分类编码的GGT都是独立的预后因素。将GGT添加到包含标准特征的模型中，可将辨别率提高0.9%至1.8%，并提高临床净效益。治疗前血清GGT是RCC患者的一个新的独立预后因素。根据GGT将患者分层为预后亚组可用于患者咨询、定制监测、个性化治疗计划和临床试验设计。
Gamma-glutamyltransferase (GGT) regulates apoptotic balance and promotes cancer progression and invasion. Higher pretherapeutic GGT serum levels have been associated with worse outcomes in various malignancies, but there are no data for renal cell carcinoma (RCC). Pretherapeutic GGT serum levels and clinicopathological parameters were retrospectively evaluated in 921 consecutive RCC patients treated with nephrectomy at a single institution between 1998 and 2013. Gamma-glutamyltransferase was analysed as continuous and categorical variable. Associations with RCC-specific survival were assessed with Cox proportional hazards models. Discrimination was measured with the C-index. Decision-curve analysis was used to evaluate the clinical net benefit. The median postoperative follow-up was 45 months. Median pretherapeutic serum GGT level was 25 U l−1. Gamma-glutamyltransferase levels increased with advancing T (P<0.001), N (P=0.006) and M stages (P<0.001), higher grades (P<0.001), and presence of tumour necrosis (P<0.001). An increase of GGT by 10 U l−1 was associated with an increase in the risk of death from RCC by 4% (HR 1.04, P<0.001). Based on recursive partitioning-based survival tree analysis, we defined four prognostic categories of GGT: normal low (<17.5 U l−1), normal high (17.5 to <34.5 U l−1), elevated (34.5 to <181.5 U l−1), and highly elevated (⩾181.5 U l−1). In multivariable analyses that adjusted for the effect of standard features, both continuously and categorically coded GGT were independent prognostic factors. Adding GGT to a model that included standard features increased the discrimination by 0.9% to 1.8% and improved the clinical net benefit. Pretherapeutic serum GGT is a novel and independent prognostic factor for patients with RCC. Stratifying patients into prognostic subgroups according to GGT may be used for patient counselling, tailoring surveillance, individualised treatment planning, and clinical trial design.
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影响因子：
8.8
作者：
Seebacher, V.;Polterauer, S.;Grimm, C.;Rahhal, J.;Hofstetter, G.;Bauer, E-M;Husslein, H.;Leipold, H.;Marth, C.;Reinthaller, A.;Concin, N.
通讯作者：
Concin, N.
影响因子：
3.2
作者：
Hanigan, MH;Frierson, HF
通讯作者：
Frierson, HF
影响因子：
2.6
作者：
Simic, Tatjana;Dragicevic, Dejan;Mimic-Oka, Jasmina
通讯作者：
Mimic-Oka, Jasmina
DOI：
10.1161/01.atv.0000251993.20372.40
发表时间：
2007-01-01
影响因子：
8.7
作者：
Lee, Douglas S.;Evans, Jane C.;Vasan, Ramachandran S.
通讯作者：
Vasan, Ramachandran S.
影响因子：
8.8
作者：
通讯作者：
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