Gamma-glutamyl transpeptidase level is a novel adverse prognostic indicator in human metastatic colorectal cancer
Gamma-glutamyl transpeptidase level is a novel adverse prognostic indicator in human metastatic colorectal cancer
复制标题
γ-谷氨酰转肽酶水平是人类转移性结直肠癌的新型不良预后指标
DOI：
10.1111/codi.12258
复制
发表时间：
2013-08-01
影响因子：
3.4
通讯作者：
Xia, L-P
中科院分区：
文献类型：
--
作者：
He, W-Z;Guo, G-F;Xia, L-P
目的生物标志物已被用于结直肠癌的预后，然而，相对较少已被确定。我们比较了血清碱性磷酸酶（ALP），方法收集2005 - 2010年中山大学附属中山医院239例转移性结直肠癌（mCRC）患者的外周血标本，检测血清乳酸脱氢酶（LDH）、γ-谷氨酰转肽酶（GGT）、癌胚抗原（CEA）、糖链抗原19-9（CA 19 -9）水平。结果CEA（P < 0.001）、CA 19 -9（P <0.001）、GGT（P <0.001）、ALP（P <0.001）、LDH（P = 0.001）是影响总生存期的重要预后因素。CEA（P = 0.002）和GGT（P = 0.021）被验证为独立的预测因子。单因素分析显示，CEA（P = 0.003）、CA 19 -9（P = 0.006）、GGT（P < 0.001）和ALP（P = 0.001）是一线化疗患者无进展生存期（PFS）的预测因素。CEA（P = 0.011）和GGT（P = 0.027）是独立的预测因子。GGT（P = 0.001）、ALP（P = 0.016）和LDH（P = 0.039）水平与CT评估的肿瘤缓解率相关，而CEA（P = 0.724）和CA 19 -9（P = 0.822）水平与肿瘤缓解率无关。结论在GGT、LDH和ALP中，只有GGT和CEA对mCRC的OS和PFS有独立的预测作用。当与CEA结合时，GGT可能导致改善的预后预测因子。
Aim Biomarkers have been utilized for prognosis in colorectal cancer; however, relatively few have been identified. We compared the prognostic value of serum alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and gamma-glutamyl transpeptidase (GGT) with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in patients with metastatic colorectal cancer (mCRC).Method Blood samples were collected from 239 patients with mCRC presenting between 2005 and 2010 in the Sun Yat-sen University Cancer Center.Results CEA (P < 0.001), CA19-9 (P < 0.001), GGT (P < 0.001), ALP (P < 0.001) and LDH (P = 0.001) were statistically significant prognostic factors of overall survival (OS). CEA (P = 0.002) and GGT (P = 0.021) were validated as independent predictors. On univariate analysis, CEA (P = 0.003), CA19-9 (P = 0.006), GGT (P < 0.001) and ALP (P = 0.001) were statistically significant predictive factors of progression-free survival (PFS) in patients having first-line chemotherapy. CEA (P = 0.011) and GGT (P = 0.027) were independent predictors. GGT (P = 0.001), ALP (P = 0.016) and LDH (P = 0.039) levels were correlated with the tumour response rate assessed by CT, whilst CEA (P = 0.724) and CA19-9 (P = 0.822) were not. There was a statistically significant difference in OS (P < 0.001) and PFS (P < 0.001) among patients who had elevations of both CEA and GGT compared with those in whom only one or neither was elevated.Conclusion Among GGT, LDH and ALP, only GGT plays an independent role with CEA in predicting OS and PFS in mCRC. When coupled with CEA, GGT may lead to improved prognostic predictors.