Abstract
ABSTRACTPurposeTo assess the relationship between De Ritis (aspartate aminotransaminase [AST]/Alanine aminotransaminase [ALT]) ratio and pathological variables and whether it is an independent prognostic factor.Materials and MethodsWe analyzed 298 consecutive patients who underwent radical or partial nephrectomy for non-metastatic renal cell carcinoma (RCC) between 2006 and 2015. The association between De Ritis ratio and pathological variables including tumor size, presence of renal vein invasion, vena cava invasion, renal capsule infiltration, Gerota fascia invasion, renal sinus involvement, renal pelvic invasion, angiolymphatic invasion, adrenal gland involvement, lymph node involvement, tumor necrosis, and Fuhrman's grade was tested. Multivariable Cox analysis was performed to evaluate the impact of this ratio on overall survival and cancer-specific survival.ResultsAn increased preoperative De Ritis ratio was significantly associated with renal vein invasion, renal capsule infiltration and renal pelvis involvement (p<0.05) in non-metastatic RCC. On multivariate analysis we found that tumor size, Fuhrman grade and lymph node involvement were independent prognostic factors for cancer-specific survival. AST/ALT ratio had no influence on the risk of overall and cancer-specific survival.ConclusionAn increased preoperative AST/ALT ratio had a significant association with renal vein invasion, renal capsule infiltration and renal pelvis involvement in patients with non-metastatic RCC. However, it does not appear to be an independent prognostic marker in non-metastatic RCC.
Highlights
Renal cell carcinoma (RCC) accounts for 3% of all malignancies and thanks to advanced radiological tools, the incidence of RCC has increased during the last decade [1, 2]
On multivariate analysis we found that tumor size, Fuhrman grade and lymph node involvement were independent prognostic factors for Cancer-specific survival (CSS) (Table-2)
The De Ritis ratio was not associated with overall and cancer-specific survival for non-metastatic RCC in the present study, we found that patients with the high AST/ALT ratio were more likely to have renal vein invasion, renal capsule infiltration, and renal pelvis involvement compared with patients in the low AST/ALT ratio
Summary
Renal cell carcinoma (RCC) accounts for 3% of all malignancies and thanks to advanced radiological tools, the incidence of RCC has increased during the last decade [1, 2]. It is important to research useful prognostic markers for the prognosis of RCC patients. Several prognostic parameters have been evaluated; stage, histologic type Fuhrman grade, several risk scores and nomograms remain crucial prognostic factors in RCC [3,4,5]. Alanine aminotransaminase (ALT) is only existent in the hepatocellular cytoplasm and mitochondria; aspartate aminotransaminase (AST) is widely spreaded ibju | De Ritis ratio and renal cell carcinoma in several organs, including heart, kidney, brain, skeletal muscle, and liver [6]. The relationship between different levels of these enzymes and patient prognosis is stated in several types of cancer, previously [7,8,9]
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