Abstract
This study was performed to evaluate the prognostic significance of the pretreatment serum gamma-glutamyltransferase (GGT) levels in a Chinese cohort of patients with early-stage or locally advanced cervical cancer. The pretreatment serum GGT levels were examined in 290 cervical cancer patients with stage I-III disease and 230 healthy controls selected from a cancer-free population in the same region. Patients were assigned to normal or high-risk GGT groups, as previously described, and the GGT levels were correlated to clinicopathologic parameters and survival data. The GGT levels in cervical cancer patients were significantly higher than those in healthy controls (35.6 ± 29.1 vs. 24.1 ± 14.7 U/L, P < 0.001). In addition, the pretreatment serum GGT levels were associated with the histology type (P = 0.023), lymph node involvement (P = 0.040), stage (P = 0.029), recurrence (P = 0.015) and death (P = 0.005), but not with age (P = 0.432), tumor size (P = 0.067) or degree of differentiation (P = 0.901). Moreover, univariate survival analysis revealed that patients with high GGT levels tended to have poorer disease-free survival (DFS) [hazard ratio (HR), 1.721; 95% confidence interval (CI), 1.189–2.491; P = 0.004] and overall survival (OS) (HR, 1.929; 95% CI, 1.294–2.876; P = 0.001) compared to those with normal GGT levels. However, a multivariate Cox-regression model did not support these data (HR, 1.373; 95% CI, 0.925–2.039; P = 0.116 for DFS and HR, 1.357; 95% CI, 0.887–2.078; P = 0.160 for OS, respectively) after adjusting for other confounding variables. High pretreatment serum GGT was associated with more advanced tumor behavior, but could not serve as an independent prognostic indicator in patients with early-stage or locally advanced cervical cancer.
Highlights
Cervical cancer is one of the most commonly diagnosed cancers and is high in incidence and mortality among women worldwide
Univariate survival analysis revealed that patients with high GGT levels tended to have poorer disease-free survival (DFS) [hazard ratio (HR), 1.721; 95% confidence interval (CI), 1.189–2.491; P = 0.004] and overall survival (OS) (HR, 1.929; 95% CI, 1.294–2.876; P = 0.001) compared to those with normal GGT levels
The serum GGT levels were significantly higher in cervical cancer patients than those of healthy controls (35.6 ± 29.1 vs. 24.1 ± 14.7 U/L, P < 0.001, Figure 1)
Summary
Cervical cancer is one of the most commonly diagnosed cancers and is high in incidence and mortality among women worldwide. Earlystage and locally advanced cervical cancer can be cured with radical surgery, chemoradiotherapy, or a combination of these treatments, patients with metastatic or recurrent disease following platinum-based chemoradiotherapy have limited options [6,7], and the prognosis remains poor. GSH has been identified as a major water-soluble antioxidant in cells and protects cells against oxidants by neutralizing reactive oxygen compounds and free radicals that are produced during normal metabolism [9,10]. GGT has gained increased attention as an independent prognostic biomarker in various malignancies, including renal cell carcinoma, ovarian cancer, endometrial cancer, as well as esophageal squamous cell carcinoma [17,18,19]. High pre-therapeutic GGT levels have been identified to be associated with advanced tumor stages, but did not predict survival in patients with cervical cancer [20]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
