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DOI QR Code

Model Based on Alkaline Phosphatase and Gamma-Glutamyltransferase for Gallbladder Cancer Prognosis

  • Xu, Xin-Sen ;
  • Miao, Run-Chen ;
  • Zhang, Ling-Qiang ;
  • Wang, Rui-Tao ;
  • Qu, Kai ;
  • Pang, Qing ;
  • Liu, Chang
  • Published : 2015.10.06

Abstract

Purpose: To evaluate the prognostic value of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) in gallbladder cancer (GBC). Materials and Methods: Serum ALP and GGT levels and clinicopathological parameters were retrospectively evaluated in 199 GBC patients. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of ALP and GGT. Then, associations with overall survival were assessed by multivariate analysis. Based on the significant factors, a prognostic score model was established. Results: By ROC curve analysis, $ALP{\geq}210U/L$ and $GGT{\geq}43U/L$ were considered elevated. Overall survival for patients with elevated ALP and GGT was significantly worse than for patients within the normal range. Multivariate analysis showed that the elevated ALP, GGT and tumor stage were independent prognostic factors. Giving each positive factor a score of 1, we established a preoperative prognostic score model. Varied outcomes would be significantly distinguished by the different score groups. By further ROC curve analysis, the simple score showed great superiority compared with the widely used TNM staging, each of the ALP or GGT alone, or traditional tumor markers such as CEA, AFP, CA125 and CA199. Conclusions: Elevated ALP and GGT levels were risk predictors in GBC patients. Our prognostic model provides infomration on varied outcomes of patients from different score groups.

Keywords

gamma-glutamyltransferase;alkaline phosphatase;gallbladder cancer;prognosis

References

  1. Du WX, Duan SF, Chen JJ, et al (2014). Serum bone-specific alkaline phosphatase as a biomarker for osseous metastases in patients with malignant carcinomas: a systematic review and meta-analysis. J Cancer Res Ther, 10, 140-3. https://doi.org/10.4103/0973-1482.145842
  2. Dutta U (2012). Gallbladder cancer: can newer insights improve the outcome? J Gastroenterol Hepatol, 27, 642-53. https://doi.org/10.1111/j.1440-1746.2011.07048.x
  3. Hann HW, Wan S, Myers RE, et al (2012). Comprehensive analysis of common serum liver enzymes as prospective predictors of hepatocellular carcinoma in HBV patients. PLoS One, 7, 47687. https://doi.org/10.1371/journal.pone.0047687
  4. He WZ, Guo GF, Yin CX, et al (2013). Gamma-glutamyl transpeptidase level is a novel adverse prognostic indicator in human metastatic colorectal cancer. Colorectal Dis, 15, 443-52. https://doi.org/10.1111/codi.12258
  5. Hofbauer SL, Stangl KI, de Martino M, et al (2014). Pretherapeutic gamma-glutamyltransferase is an independent prognostic factor for patients with renal cell carcinoma. Br J Cancer, 111, 1526-31. https://doi.org/10.1038/bjc.2014.450
  6. Kunutsor SK, Apekey TA, Van Hemelrijck M, et al (2015). Gamma glutamyltransferase, alanine aminotransferase and risk of cancer: systematic review and meta-analysis. Int J Cancer, 136, 1162-70. https://doi.org/10.1002/ijc.29084
  7. Lazcano-Ponce EC, Miquel JF, Munoz N, et al (2001). Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin, 51, 349-64. https://doi.org/10.3322/canjclin.51.6.349
  8. Leung TW, Tang AM, Zee B, et al (2002). Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study based on 926 patients. Cancer, 94, 1760-9. https://doi.org/10.1002/cncr.10384
  9. Li M, Zhang Z, Li X, et al (2014). Whole-exome and targeted gene sequencing of gallbladder carcinoma identifies recurrent mutations in the ErbB pathway. Nat Genet, 46, 872-6. https://doi.org/10.1038/ng.3030
  10. Lopez JB, Balasegaram M, Thambyrajah V, et al (1996). The value of liver function tests in hepatocellular carcinoma. Malays J Pathol, 18, 95-9.
  11. Ma H, Zhang L, Tang B, et al (2014). gamma- Glutamyltranspeptidase is a prognostic marker of survival and recurrence in radiofrequency-ablation treatment of hepatocellular carcinoma. Ann Surg Oncol, 21, 3084-9. https://doi.org/10.1245/s10434-014-3724-4
  12. Pratt DS, Kaplan MM (2000). Evaluation of abnormal liverenzyme results in asymptomatic patients. N Engl J Med, 342, 1266-71. https://doi.org/10.1056/NEJM200004273421707
  13. Ruhl CE, Everhart JE (2009). Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population. Gastroenterology, 136, 477-85. https://doi.org/10.1053/j.gastro.2008.10.052
  14. Saif MW, Alexander D, Wicox CM (2005). Serum Alkaline Phosphatase Level as a Prognostic Tool in Colorectal Cancer: A Study of 105 patients. J Appl Res, 5, 88-95.
  15. Shu YJ, Weng H, Ye YY, et al (2015). SPOCK1 as a potential cancer prognostic marker promotes the proliferation and metastasis of gallbladder cancer cells by activating the PI3K/ AKT pathway. Mol Cancer, 14, 12. https://doi.org/10.1186/s12943-014-0276-y
  16. Siegel RL, Miller KD, Jemal A (2015). Cancer statistics, 2015. CA Cancer J Clin, 65, 5-29. https://doi.org/10.3322/caac.21254
  17. Sonpavde G, Pond GR, Berry WR, et al (2012). Serum alkaline phosphatase changes predict survival independent of PSA changes in men with castration-resistant prostate cancer and bone metastasis receiving chemotherapy. Urol Oncol, 30, 607-13. https://doi.org/10.1016/j.urolonc.2010.07.002
  18. Wang GY, Yang Y, Li H, et al (2011). A scoring model based on neutrophil to lymphocyte ratio predicts recurrence of HBV-associated hepatocellular carcinoma after liver transplantation. PLoS One, 6, 25295. https://doi.org/10.1371/journal.pone.0025295
  19. Wang SJ, Fuller CD, Kim JS, et al (2008). Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer. J Clin Oncol, 26, 2112-7. https://doi.org/10.1200/JCO.2007.14.7934
  20. Xie Y, Wei ZB, Duan XW (2014). Prognostic value of pretreatment serum alkaline phosphatase in nasopharyngeal carcinoma. Asian Pac J Cancer Prev, 15, 3547-53. https://doi.org/10.7314/APJCP.2014.15.8.3547
  21. Xu XS, Wan Y, Song SD, et al (2014). Model based on gamma-glutamyltransferase and alkaline phosphatase for hepatocellular carcinoma prognosis. World J Gastroenterol, 20, 10944-52. https://doi.org/10.3748/wjg.v20.i31.10944
  22. Yamamoto K, Awogi T, Okuyama K, et al (2003). Nuclear localization of alkaline phosphatase in cultured human cancer cells. Med Electron Microsc, 36, 47-51. https://doi.org/10.1007/s007950300006
  23. Yang F, Zhang S, Yang H, et al (2014). Prognostic significance of gamma-glutamyltransferase in patients with resectable esophageal squamous cell carcinoma. Dis Esophagus [Epub ahead of print].
  24. Yin X, Zheng SS, Zhang BH, et al (2013). Elevation of serum gamma-glutamyltransferase as a predictor of aggressive tumor behaviors and unfavorable prognosis in patients with intrahepatic cholangiocarcinoma: analysis of a large monocenter study. Eur J Gastroenterol Hepatol, 25, 1408-14. https://doi.org/10.1097/MEG.0b013e328364130f

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Acknowledgement

Supported by : Natural Science Foundation of China