Abstract
BackgroundThe 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.MethodsOur 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.ResultsLFTs 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).ConclusionsBoth 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.
Highlights
The levels of liver function tests (LFTs) are often used to assess liver injury and non-liver disease-related mortality
Our findings suggest that serum level of ALT/AST ratio (LSR) and gamma glutamyltransferase (GGT) levels could be used as a key predictor of survival in patients with esophageal squamous cell carcinoma (ESCC)
Among the 447 ESCC cases examined in this retrospective study from Sun Yat-Sen University Cancer Center, we observed that patients with higher LSR levels showed significantly better prognosis compared with those patients with low LSR levels, in the entire cohort and in the subgroups stratified by pathological stage (T1–T2 subgroup, T3–T4 subgroup, N0 subgroup and M0 subgroup)
Summary
The levels of liver function tests (LFTs) are often used to assess liver injury and non-liver disease-related mortality. The relationship between pretreatment serum LFTs and overall survival (OS) was evaluated in esophageal squamous cell carcinoma (ESCC) patients. Esophageal cancer is one of the most prevalent malignant diseases worldwide, among all histologic types, esophageal squamous cell carcinoma (ESCC) occupies major portion [1, 2], and has the sixth mortality rates of any cancer globally. As treatment plans are becoming more individualized for each patient, it is important to assess disease progression in a timely manner while accurately evaluating the prognosis [5]. Various serum biomarkers, such as SCC, CYFRA21-1and CEA, have been served as the valuable markers to estimate the prognosis of ESCC patients [6]. In order to improve the posttreatment survival of patients, identification of more effective and accurate biomarker of ESCC is a necessity
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