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Pichardo-Rojas PS, Dono A, Ballester LY, Esquenazi Y. Novel Postoperative Serum Biomarkers in Atypical Meningiomas: A Multicenter Study. Neurosurgery 2023; 93:599-610. [PMID: 36921247 PMCID: PMC10827320 DOI: 10.1227/neu.0000000000002457] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/18/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND There has been no known serum biomarker to predict the prognosis of atypical meningioma. OBJECTIVE To investigate the prognostic impact of serum biomarkers in patients newly diagnosed with resected intracranial atypical meningiomas. METHODS This study enrolled 523 patients with atypical meningioma who underwent surgical resection between 1998 and 2018 from 5 Asian institutions. Serum laboratory data within 1 week after surgery were obtained for analysis. Optimal cutoffs were calculated for each serum marker using the maxstat package of R. RESULTS Of 523 patients, 19.5% underwent subtotal resection and 29.8% were treated with adjuvant radiation therapy (ART). Among the 523 patients, 454 were included in the multivariate analysis for the progression/recurrence (P/R) rate excluding patients with incomplete histopathologic or laboratory data. On multivariate analysis, tumor size >5 cm, subtotal resection, and postoperative aspartate aminotransferase/alanine transaminase (De Ritis) ratio >2 were associated with higher P/R rates, whereas ART and postoperative platelet count >137 × 10 3 /μL were associated with lower P/R rates. In the subgroup of patients treated with ART, tumor size >5 cm and postoperative neutrophil-to-lymphocyte ratio >21 were associated with higher P/R rates. By contrast, postoperative De Ritis ratio >2 remained an adverse prognosticator in patients not treated with ART. CONCLUSION Postoperative De Ritis ratio, platelet count, and neutrophil-to-lymphocyte ratio were revealed as a novel serum prognosticator in newly diagnosed atypical meningiomas. Additional studies are warranted to validate its clinical significance and biological background.
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Affiliation(s)
- Pavel S. Pichardo-Rojas
- Vivian L. Smith Department of Neurosurgery, McGovern
Medical School, the University of Texas Health Science Center at Houston, TX
| | - Antonio Dono
- Vivian L. Smith Department of Neurosurgery, McGovern
Medical School, the University of Texas Health Science Center at Houston, TX
| | - Leomar Y. Ballester
- Department of Pathology, The University of Texas MD
Anderson Cancer Center, Houston, Texas 77030, USA
- Department of Translational Molecular Pathology, The
University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Yoshua Esquenazi
- Vivian L. Smith Department of Neurosurgery, McGovern
Medical School, the University of Texas Health Science Center at Houston, TX
- Memorial Hermann Hospital-TMC, Houston, TX
- Center for Precision Health, School of Biomedical
Informatics, McGovern Medical School, the University of Texas Health Science Center
at Houston, TX
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Duan J, Zhao Y, Pei F, Deng W, He L, Rao C, Zhai Y, Zhang C. Swietenine inhibited oxidative stress through AKT/Nrf2/HO-1 signal pathways and the liver-protective effect in T2DM mice: In vivo and in vitro study. ENVIRONMENTAL TOXICOLOGY 2023; 38:1292-1304. [PMID: 36880193 DOI: 10.1002/tox.23764] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/03/2023] [Accepted: 02/20/2023] [Indexed: 05/18/2023]
Abstract
Swietenia macrophylla King, belongs to the Meliaceae family, is a valuable medicinal plant and its fruits have been processed commercially to a variety of health foods. The seeds have long been known for their ethnomedicinal significance against these diseases. Swietenine (Swi) was isolated from S. macrophylla and could ameliorate inflammation and oxidative stress. In this study, HepG2 cells induced by H2 O2 were used to construct oxidative stress model in vitro. The aim of this study was to investigate the protective effect of Swi on H2 O2 induced oxidative injury in HepG2 cells and its molecular mechanism, and to explore the effect of Swi on liver injury in db/db mice and its possible mechanism. The results showed that Swi significantly inhibited HepG2 cells viability and reduced oxidative damage in a dose-dependent manner as evidenced by a range of biochemical analysis and immunoblotting study. Moreover, it induced the protein and mRNA expression of HO-1 together with its upstream mediator Nrf2 and activated the phosphorylation of AKT in HepG2 cells. LY294002, a PI3K/AKT inhibitor, significantly suppressed the Nrf2 nuclear translocation and HO-1 expression in H2 O2 induced HepG2 cells treated with Swi. In addition, RNA interference with Nrf2 significantly reduced the expression level of Nrf2 and HO-1 in the nucleus. Swi has a significant protective effect on cell damage in H2 O2 induced HepG2 cells by increasing the antioxidant capacity which is achieved through the AKT/Nrf2/HO-1 pathway. Additionally, in vivo, Swi could protect the liver of type 2 diabetic mice by improving lipid deposition in liver tissue and inhibiting oxidative stress. These findings indicated that Swi can be a promising dietary agent to improve type 2 diabetes.
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Affiliation(s)
- Jingyu Duan
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Yangqi Zhao
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Feilong Pei
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Wenhao Deng
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Liangliang He
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Chengdian Rao
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Yutong Zhai
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Chunping Zhang
- School of Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, People's Republic of China
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3
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Kapoor D, Perwaiz A, Singh A, Kumar AN, Chaudhary A. Factors predicting 30-day mortality after pancreaticoduodenectomy-the impact of elevated aspartate aminotransferase. Langenbecks Arch Surg 2023; 408:130. [PMID: 36991246 DOI: 10.1007/s00423-023-02865-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/19/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE High preoperative bilirubin levels and cholangitis are associated with poor peri-operative outcomes following pancreaticoduodenectomy (PD). However, the impact of deranged preoperative aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels on immediate postoperative outcomes is relatively unexplored. We hypothesized that deranged AST and ALT lead to worse postoperative outcomes after PD. The aim of this study was to assess the factors contributing to postoperative mortality (POM) following PD, and to study the impact of deranged aminotransferases. METHODS This is a retrospective analysis of 562 patients. Risk factors for POM were computed using a multivariate logistic regression model. RESULTS The rate of POM was 3.9%. On univariate analysis, the American Society of Anaesthesiologists grades, diabetes mellitus, cardiac comorbidity, preoperative biliary stenting, elevated serum bilirubin, AST, elevated serum creatinine, clinically relevant pancreatic fistula (CRPF), and grade B+C post-pancreatectomy hemorrhage (PPH) were associated with 30-day mortality. On multivariate analysis, preoperative elevated AST was independently predictive of 30-day POM (OR = 6.141, 95%CI 2.060-18.305, p = 0.001). Other factors independently predictive of POM were elevated serum creatinine, preoperative biliary stenting, CRPF and grade B and C PPH. The ratio of AST/ALT > 0.89 was associated with 8 times increased odds of POM. CONCLUSION Elevated preoperative AST emerged as a predictor of 30-day POM after PD, with an 8-times increased odds of death with an AST/ALT ratio > 0.89.
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Affiliation(s)
- Deeksha Kapoor
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India
| | - Azhar Perwaiz
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India
| | - Amanjeet Singh
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India
| | - Arun N Kumar
- Department of Data Science, Alke Research Private Limited, Bengaluru, Karnataka, India
| | - Adarsh Chaudhary
- Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Institute of Digestive and Hepatobiliary Sciences, Medanta - the Medicity, Sector 38, Gurugram, Haryana, 122001, India.
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Ahmadabad MA, Naeimi A, Keymoradzadeh A, Faghani S, Ahmadabad MA, Boroujeni NA, Mohammadpour H, Saberi A. Evaluation of De Ritis (AST/ALT), ALP/ALT, and AST/ALP ratios as prognostic factors in patients with acute ischemic stroke. BMC Neurol 2022; 22:450. [PMID: 36463106 PMCID: PMC9719238 DOI: 10.1186/s12883-022-02989-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Stroke is one of the leading causes of disability worldwide. Recently, stroke prognosis estimation has received much attention. This study investigates the prognostic role of aspartate transaminase/alanine transaminase (De Ritis, AAR), alkaline phosphatase/alanine transaminase (ALP/ALT), and aspartate transaminase/alkaline phosphatase (AST/ALP) ratios in acute ischemic stroke (AIS). METHODS This retrospective cohort study involved patients who experienced their first-ever AIS between September 2019 and June 2021. Clinical and laboratory data were collected within the first 24 hours after admission. Functional and mortality outcomes were evaluated 90 days after hospital discharge in clinical follow-up. Functional outcome was assessed by a modified Rankin Scale (mRS). The correlation between the laboratory data and study outcomes was evaluated using univariate analysis. In addition, regression models were developed to evaluate the predictive role of AST/ALP, ALP/ALT, and AAR ratios on the study outcomes. RESULTS Two hundred seventy-seven patients (mean age 69.10 ± 13.55, 53.1% female) were included. According to univariate analysis, there was a weak association between 3-months mRS, and both AST/ALT (r = 0.222, P < 0.001), and AST/ALP (r = 0.164, P = 0.008). Subsequently, higher levels of these ratios and absolute values of AST, ALT, and ALP were reported in deceased patients. Based on regression models adjusted with co-variable (age, gender, underlying disease, and history of smoking) AST/ALT and AST/ALP ratios had a significant independent association with 3-month mRS (CI:1.37-4.52, p = 0.003, and CI: 4.45-11,547.32, p = 0.007, respectively) and mortality (CI: 0.17-1.06, adjusted R2 = 0.21, p = 0.007, and CI: 0.10-2.91, p = 0.035, adjusted R2 = 0.20, respectively). CONCLUSIONS Elevated AST/ALP and AAR ratios at admission were correlated with poorer outcomes at 3 months in patients with first-ever AIS. Prospective studies in larger cohorts are required to confirm our findings and to evaluate further whether the AST/ALP and De Ritis ratios may represent a useful tool for determining the prognosis of AIS patients.
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Affiliation(s)
- Mona Asghari Ahmadabad
- grid.411874.f0000 0004 0571 1549Neurosciences Research Center, Neurology Department, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Arvin Naeimi
- grid.411874.f0000 0004 0571 1549Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Arman Keymoradzadeh
- grid.411600.2Department of Neurosurgery, School of Medicine Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahriar Faghani
- grid.411705.60000 0001 0166 0922Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Asghari Ahmadabad
- grid.411874.f0000 0004 0571 1549Neurosciences Research Center, Neurology Department, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Nasim Athari Boroujeni
- grid.411874.f0000 0004 0571 1549Neurosciences Research Center, Neurology Department, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Hanieh Mohammadpour
- grid.411874.f0000 0004 0571 1549Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Alia Saberi
- grid.411874.f0000 0004 0571 1549Neurosciences Research Center, Neurology Department, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Wang Y, Liu C, Zhang N, Song X, Song Y, Cai D, Fang K, Chang X. Anti-PADI4 antibody suppresses breast cancer by repressing the citrullinated fibronectin in the tumor microenvironment. Biomed Pharmacother 2022; 153:113289. [DOI: 10.1016/j.biopha.2022.113289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022] Open
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Bel’skaya LV, Sarf EA. Prognostic Value of Salivary Biochemical Indicators in Primary Resectable Breast Cancer. Metabolites 2022; 12:metabo12060552. [PMID: 35736486 PMCID: PMC9227854 DOI: 10.3390/metabo12060552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023] Open
Abstract
Despite the fact that breast cancer was detected in the early stages, the prognosis was not always favorable. In this paper, we examined the impact of clinical and pathological characteristics of patients and the composition of saliva before treatment on overall survival and the risk of recurrence of primary resectable breast cancer. The study included 355 patients of the Omsk Clinical Oncology Center with a diagnosis of primary resectable breast cancer (T1-3N0-1M0). Saliva was analyzed for 42 biochemical indicators before the start of treatment. We have identified two biochemical indicators of saliva that can act as prognostic markers: alkaline phosphatase (ALP) and diene conjugates (DC). Favorable prognostic factors were ALP activity above 71.7 U/L and DC level above 3.93 c.u. Additional accounting for aspartate aminotransferase (AST) activity allows for forming a group with a favorable prognosis, for which the relative risk is reduced by more than 11 times (HR = 11.49, 95% CI 1.43-88.99, p = 0.01591). Salivary AST activity has no independent prognostic value. Multivariate analysis showed that tumor size, lymph nodes metastasis status, malignancy grade, tumor HER2 status, and salivary ALP activity were independent predictors. It was shown that the risk of recurrence decreased with menopause and increased with an increase in the size of the primary tumor and lymph node involvement. Significant risk factors for recurrence were salivary ALP activity below 71.7 U/L and DC levels below 3.93 c.u. before treatment. Thus, the assessment of biochemical indicators of saliva before treatment can provide prognostic information comparable in importance to the clinicopathological characteristics of the tumor and can be used to identify a risk group for recurrence in primary resectable breast cancer.
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Elevated AST/ALT ratio is associated with all-cause mortality in patients with stable coronary artery disease: a secondary analysis based on a retrospective cohort study. Sci Rep 2022; 12:9231. [PMID: 35654995 PMCID: PMC9163143 DOI: 10.1038/s41598-022-13355-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to explore the association between the aspartate amino transferase (AST)/alanine aminotransferase (ALT) ratio and all-cause mortality (ACM) in stable coronary artery disease (CAD) patients treated by percutaneous coronary intervention (PCI). The study is a secondary analysis of a retrospective cohort study involving 203 stable CAD patients. Patients were divided into two groups, based on the optimal AST/ALT ratio threshold calculated by the ROC curve (low group: AST/ALT ratio < 1.40; high group: AST/ALT ratio ≥ 1.40). Results were compared using hazard ratio (HR) and a 95% confidence interval (CI). ACM occurred in 18 patients after an average follow-up time of 749 (435–1122) days. Among them, ACM occurred in 6 patients in the low group and 12 patients in the high group, with significant differences between the groups (4.65% versus 16.22%, P value = 0.005). In the Kaplan–Meier analysis, an elevated AST/ALT ratio was associated with increased ACM in stable ACD patients (HR 3.78, 95% CI 1.44–9.93, P value < 0.001). An elevated AST/ALT ratio was still found to be an independent prognostic factor for ACM (HR 2.93, 95% CI 1.08–7.91, P value = 0.034) after adjusting for potential confounders. Therefore, an elevated AST/ALT ratio is an independent prognostic factor for ACM in stable ACD patients.
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Wang B, Hu L, Chen Y, Zhu B, Kong W, Zhu Z, Wang K, Yu Q, Zhang W, Wu G, Sun Y, Xia Z. Aspartate transaminase/alanine transaminase (De Ritis ratio) predicts survival in major burn patients. Burns 2022; 48:872-879. [PMID: 34456097 DOI: 10.1016/j.burns.2021.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although treatment of burn patients has significantly improved in recent decades, major burns remain fatal. Therefore, the evaluation of the death risk of the patients with extensive burns is very important. The ratio between the serum levels of aspartate transaminase and alanine transaminase (De Ritis ratio) was an independent predictor of poor outcomes in patients with acute ischemic stroke, cardiac surgery, non-metastatic renal cell carcinoma, and upper urinary tract urothelial carcinoma. Our aim was to determine whether the ratio between the serum levels of AST and ALT (De Ritis ratio) was useful to assess prognosis in extensively burned patients. METHODS We conducted a single-center cohort study at the Burns Department of Changhai Hospital. This retrospective observational analysis was performed based on the clinical data of major burn patients admitted between May 1, 2005 and April 30, 2018. Univariate and multivariate logistic regression analyses were performed on variables such as age, sex, total body surface area (TBSA), De Ritis ratio, and serum albumin level, which may affect mortality in major burn patients. We assessed their diagnostic value and found the cut-off value by receiver operative characteristic (ROC) curve analysis. We used the Kaplan-Meier curve to display the impact of the De Ritis ratio and serum albumin level on survival in burn patients. RESULTS A total of 351 patients with extensive burns were included in the study. The cohort predominantly consisted of males (74.64%), and most of the patients (78.35%) had been burned by a flame. Age, TBSA, inhalation, and the De Ritis ratio were found to be independent risk factors for the 30-days mortality of major burn patients, while age, TBSA, inhalation, and the De Ritis ratio were independent risk factors for 90-day mortality. Further, the De Ritis ratio was a better mortality predictor than serum albumin in severely burned patients, whose area under ROC for 30-day and 90-day mortality was 0.771 (95% confidence intervals [CI], 0.708-0.835) and 0.750 (95% CI, 0.683, 0.818). CONCLUSIONS The De Ritis ratio was useful as a prognostic indicator for major burn patients, which can be conveniently obtained through blood examination. Regardless of whether the prediction was for 30-day or 90-day mortality, the accuracy remained high. Moreover, compared to serum albumin level, the De Ritis ratio was superior in assessing the prognosis of extensively burned patients.
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Affiliation(s)
- Baoli Wang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China; Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, People's Republic of China; Department of Burns and Plastic Surgery, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan 430070, People's Republic of China.
| | - Lunyang Hu
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China; Department of Critical Care Medicine, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, People's Republic of China.
| | - Yukun Chen
- Department of Medical Imaging, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, People's Republic of China.
| | - Banghui Zhu
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
| | - Weishi Kong
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
| | - Zhe Zhu
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
| | - Kangan Wang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
| | - Qing Yu
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
| | - Wei Zhang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
| | - Guosheng Wu
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China; Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, People's Republic of China.
| | - Yu Sun
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China; Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, People's Republic of China.
| | - Zhaofan Xia
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China; Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, People's Republic of China.
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Li W, Yue L, Sun L, Xiao S. An Increased Aspartate to Alanine Aminotransferase Ratio Is Associated With a Higher Risk of Cognitive Impairment. Front Med (Lausanne) 2022; 9:780174. [PMID: 35463002 PMCID: PMC9021637 DOI: 10.3389/fmed.2022.780174] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Recent Alzheimer's disease (AD) hypotheses implicate that hepatic metabolic disorders might contribute to the disease pathogenesis of AD, but the mechanism remains unclear. Aims To investigate whether the elevated aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ratio is associated with future cognitive decline, and to explore the possible mechanisms of liver enzymes affecting cognitive function. Methods Three different clinical cohorts were included in the current study, including one cross-sectional study (Cohort 1) and two longitudinal follow-up studies (Cohort 2 and 3). All participants completed a detailed clinical evaluation, neuropsychological tests, and liver enzyme tests. In addition, some of them also underwent structural magnetic resonance imaging (MRI) scans. Results Cohort 1 was derived from the CRC2017ZD02 program, including 135 amnestic mild cognitive impairment (aMCI) patients, 22 AD patients, and 319 normal controls. In this cross-sectional study, we found that the AST/ALT ratio was associated with AD (p = 0.014, OR = 1.848, 95%CI: 1.133∼3.012), but not aMCI; Cohort 2 was derived from the Shanghai Brain Health Program. A total of 260 community elderly people with normal cognitive function were included in the study and followed up for 2 years. In this 2-year longitudinal follow-up study, we found that a higher AST/ALT ratio was a risk factor for future development of aMCI (p = 0.014, HR = 1.848, 95%CI: 1.133∼3.021); Cohort 3 was derived from the China longitudinal aging study (CLAS) Program. A total of 94 community elderly people with normal cognitive function were followed up for 7 years, and all of them completed MRI scans. In this 7-year longitudinal follow-up study, we found that a higher AST/ALT ratio was a risk factor for future development of aMCI (p = 0.006, HR = 2.247, 95%CI: 1.248∼4.049), and the AST/ALT ratio was negatively correlated with right hippocampal volume (r = -0.148, p = 0.043). Conclusion An increased ratio of AST to ALT is associated with a higher risk of cognitive impairment and may impair cognitive function by affecting hippocampal volume.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Galler M, Rogasch JMM, Huang K, Jann H, Plehm K, Wetz C, Amthauer H. Prognostic Value of the Largest Lesion Size for Progression-Free Survival in Patients with NET Undergoing Salvage PRRT with [177Lu]Lu-DOTATOC. Cancers (Basel) 2022; 14:cancers14071768. [PMID: 35406540 PMCID: PMC8996884 DOI: 10.3390/cancers14071768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Peptide receptor radionuclide therapy (PRRT) using radionuclide-labeled somatostatin analogues is based on the overexpression of somatostatin receptors on neuroendocrine tumors and is shown to have a good safety profile and efficacy in different types of metastatic neuroendocrine tumors. As this therapy is usually not curative, most patients experience disease progression after initial PRRT. In these cases, retreatment with PRRT, also called salvage PRRT, can be a treatment option, but little is known about the efficacy and possible risk factors. In this retrospective study that included 32 patients, we found that the size of the largest lesion is a significant predictor of disease progression after salvage PRRT. This risk factor is easy to obtain and can help identify patients who may benefit from intensified follow-up strategies. Abstract (1) Background: retreatment with radionuclide-labeled somatostatin analogues following disease progression after initial treatment cycles is often referred to as salvage peptide receptor radionuclide therapy (salvage PRRT). Salvage PRRT is shown to have a favorable safety profile in patients with metastatic neuroendocrine tumors (NETs), but numerous questions about the efficacy and prognostic or predictive factors remain to be answered. The purpose of this study was to evaluate two parameters that have shown prognostic significance in progression-free survival (PFS) in initial PRRT treatment, namely the size of the largest lesion (LLS) and the De Ritis ratio (aspartate aminotransferase (AST)/alanine aminotransferase (ALT)), as prognostic factors in the context of salvage PRRT. In addition, the PFS after initial PRRT was evaluated as a predictor of the PFS following salvage PRRT. (2) Methods: retrospective, monocentric analysis in 32 patients with NETs (gastroenteropancreatic, 23; unknown primary, 7; kidney, 1; lung, 1) and progression after initial PRRT undergoing retreatment with [177Lu]Lu-DOTATOC. The prognostic values of LLS, the De Ritis ratio, and PFS after initial treatment cycles regarding PFS following salvage PRRT were evaluated with univariable and multivariable Cox regression. PFS was defined as the time from treatment start until tumor progression according to RECIST 1.1 criteria, death from any cause or start of a new treatment due to progression of cancer-related symptoms (namely carcinoid syndrome). (3) Results: progression after salvage PRRT was observed in 29 of 32 patients with median PFS of 10.8 months (95% confidence interval (CI), 8.0–15.9 months). A higher LLS (hazard ratio (HR): 1.03; p = 0.002) and a higher De Ritis ratio (HR: 2.64; p = 0.047) were associated with shorter PFS after salvage PRRT in univariable Cox regression. PFS after initial PRRT was not associated with PFS following salvage PRRT. In multivariable Cox regression, only LLS remained a significant predictor. (4) Conclusions: the size of the largest lesion is easy to obtain and might help identify patients at risk of early disease progression after salvage PRRT. Validation is required.
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Affiliation(s)
- Markus Galler
- Department of Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (J.M.M.R.); (K.H.); (C.W.); (H.A.)
- Correspondence:
| | - Julian M. M. Rogasch
- Department of Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (J.M.M.R.); (K.H.); (C.W.); (H.A.)
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Kai Huang
- Department of Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (J.M.M.R.); (K.H.); (C.W.); (H.A.)
| | - Henning Jann
- Department of Hepatology and Gastroenterology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (H.J.); (K.P.)
| | - Kristina Plehm
- Department of Hepatology and Gastroenterology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (H.J.); (K.P.)
| | - Christoph Wetz
- Department of Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (J.M.M.R.); (K.H.); (C.W.); (H.A.)
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (J.M.M.R.); (K.H.); (C.W.); (H.A.)
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11
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Kobayashi D, Yamamoto K, Kimura T, Shimbo T. Aspartate aminotransferase/alanine aminotransferase ratio and subsequent cancer development. Cancer Med 2021; 11:798-814. [PMID: 34850600 PMCID: PMC8817090 DOI: 10.1002/cam4.4473] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/15/2021] [Accepted: 11/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background We aimed to evaluate the association between the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio and subsequent development of any type of cancer in an apparently healthy population. Methods We conducted a retrospective cohort study at St. Luke's International Hospital, Tokyo, Japan between 2005 and 2018. All participants who visited for voluntary health checkups were included. We divided the participants into different quintiles based on the baseline AST/ALT ratios and examined the outcomes. Results A total of 85,658 participants were included. The mean age was 44.7 years (standard deviation 12.0) at baseline, and 42,913 (50.1%) of them were men. During a median follow‐up of 61.6 months, 4701 (5.5%) participants developed some type of cancer. Compared with the middle AST/ALT ratio group, no other groups had similar adjusted hazard ratios (HR) for the development of any type of cancer in both men and women. When stratified by alcohol consumption, very high (adjusted HR 1.36; 95% CI 1.13–1.63) and high (adjusted HR 1.26; 95% CI 1.05–1.50) AST/ALT ratio groups among men who were regular drinkers had increased adjusted HRs for any type of cancer development, but the very high AST/ALT ratio group among men who were abstainers (adjusted HR 0.64; 95% CI 0.42–0.97) and very low AST/ALT ratio group among men who were occasional drinkers (adjusted HR 0.69; 95% CI 0.48–0.98) had lower adjusted HRs compared with the middle AST/ALT ratio group. Among women, regardless of alcohol consumption, adjusted HR for any type of cancer development was similar across all AST/ALT ratio groups. Conclusion People with higher AST/ALT ratios tended to have a higher risk of developing any type of cancer among men who were regular drinkers, but this risk was lower among men who were abstainers. Among women, regardless of alcohol consumption, there was no association between the development of any type of cancer and AST/ALT ratio.
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Affiliation(s)
- Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan.,Department of Epidemiology, St. Luke's International University Graduate School of Public Health, Tokyo, Japan.,Fujita Health University, Toyoake, Japan.,Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kazuki Yamamoto
- Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan
| | - Takeshi Kimura
- The Center for Preventive Medicine, St. Luke's International Hospital, Tokyo, Japan
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12
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Ghahari M, Salari A, Ghafoori Yazdi M, Nowroozi A, Fotovat A, Momeni SA, Nowroozi MR, Amini E. Association Between Preoperative De Ritis (AST/ALT) Ratio and Oncological Outcomes Following Radical Cystectomy in Patients With Urothelial Bladder Cancer. Clin Genitourin Cancer 2021; 20:e89-e93. [PMID: 34866017 DOI: 10.1016/j.clgc.2021.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Radical cystectomy in combination with neoadjuvant chemotherapy is the standard of care for muscle invasive bladder cancer (BC). However, response to treatment varies between patients. Considering the role of hepatic glucose metabolism in urothelial cancer, AST/ALT ratio (De Ritis ratio) has the potential to serve as a prognostic factor for bladder cancer and a predictor for treatment outcome. MATERIALS AND METHODS We retrospectively analyzed patients who underwent radical cystectomy between March 2016 - March 2019. Patients were classified into 2 groups based on De Ritis ratio (< 1.3 [normal] vs. ≥ 1.3 [high]). Demographics, disease severity, treatment status, and disease outcome (90-day mortality and overall survival [OS]) were compared between 2 groups. RESULTS A total of 89 patients were included, 62.9% of them having a De Ritis ratio of < 1.3 and 37.1% with a De Ritis ratio of ≥ 1.3. Mean OS was significantly higher in patients with normal De Ritis ratio (40.84 vs. 18.28 months, P < .001), and 90-day mortality rate was lower in these patients (8.9% vs. 36.4%, P = .001). Moreover, De Ritis ratio was the sole independent predictor of OS in multivariable regression analysis. CONCLUSION De Ritis ratio is an independent prognostic factor in BC patients who underwent radical cystectomy. Furthermore, higher De Ritis ratio is associated with worse OS and a higher 90-day mortality rate after surgery, and therefore, has the potential to serve as a predictor of treatment outcome in BC patients.
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Affiliation(s)
- Mohammadreza Ghahari
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Salari
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Nowroozi
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Fotovat
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Momeni
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Erfan Amini
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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13
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Liu H, Ding C, Hu L, Li M, Zhou W, Wang T, Zhu L, Bao H, Cheng X. The association between AST/ALT ratio and all-cause and cardiovascular mortality in patients with hypertension. Medicine (Baltimore) 2021; 100:e26693. [PMID: 34397804 PMCID: PMC8341222 DOI: 10.1097/md.0000000000026693] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/18/2021] [Indexed: 01/04/2023] Open
Abstract
Previous studies had shown that an increased aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) was associated with cardiovascular disease. This study aimed to assess the relationship between AST/ALT ratio and all-cause and cardiovascular mortality in patients with hypertension.By March 31, 2020, a cohort of 14,220 Chinese hypertensive patients was followed up. The end point was all-cause and cardiovascular death. Hazard ratios (HRs) and 95% CIs were calculated for mortality associated with AST/ALT ratio, using Cox proportional hazards models and competing risk model.In an average of 1.7 years of follow-up, 1.39% (n = 198) of patients died, 55.5% (n = 110) of whom from cardiovascular disease. AST/ALT ratio was associated with increased risk of all-cause death (HR:1.37, 95% CI:1.15-1.63) and cardiovascular death (HR:1.32, 95% CI:1.03-1.68) after adjustment for other potential confounders. Compared with low AST/ALT ratio (Tertile 1), high AST/ALT ratio was associated with high cause mortality (Tertile 2: HR:1.35, 95% CI:0.86-2.10; Tertile 3: HR:2.10, 95% CI:1.37-3.21; P for trend <.001). Compared with low AST/ALT ratio (Tertile 1), a statistically significant increased risk of cardiovascular mortality was also observed (Tertile 2: HR:1.27, 95% CI:0.70-2.29; Tertile 3: HR:1.92, 95% CI:1.09-3.37; P for trend <.001). High AST/ALT ratio was also associated with high cardiovascular mortality (Tertile 2: HR:1.27, 95% CI:0.70-2.29; Tertile 3: HR:1.92, 95% CI:1.09-3.37; P for trend <.001).Present study indicated that increased AST/ALT ratio levels were predictive of all-cause and cardiovascular mortality among Chinese hypertensive patients.Trial registration: CHICTR, CHiCTR1800017274. Registered 20 July 2018.
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Affiliation(s)
- Hui Liu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Congcong Ding
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Minghui Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Huihui Bao
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Xiaoshu Cheng
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
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14
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De Ritis Ratio as a Significant Prognostic Factor in Patients with Sepsis: A Retrospective Analysis. J Surg Res 2021; 264:375-385. [PMID: 33848836 DOI: 10.1016/j.jss.2021.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/20/2021] [Accepted: 03/03/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE This study was performed to investigate the relationship between the aspartate transaminase and/or alanine transaminase ratio (DRR) and long-term mortality of patients diagnosed with sepsis or septic shock. MATERIALS AND METHODS We conducted a retrospective study among adult septic patients who were admitted to the surgical intensive care unit (ICU) of the Chinese People's Liberation Army (PLA) General Hospital from January 2014 to December 2018. Baseline characteristics were compared between survivors and non survivors. We performed univariate and multivariate Cox regression analyses to evaluate the relation of DRR with 180-day mortality. The potential prognostic value of DRR in predicting mortality rate was assessed by receiver operating characteristic (ROC) curve analysis. In addition, we conducted subgroup analysis by the optimal DRR cutoff value. RESULTS We included a total of 183 patients in the current study, and 44 (24%) patients died within 180 days of hospitalization. Univariate and multivariate Cox analyses revealed that DRR was an independent predictor of 180-day mortality (hazard ratio [HR] 1.421, 95% confidence interval [CI] 1.073-1.883, P = 0.014). The predictive accuracy of DRR for 180-day mortality was presented as an ROC curve, which had an area under the curve (AUC) of 0.708 (95% CI 0.629-0.786, P < 0.001). After we stratified all enrolled patients into two groups by using the optimal cutoff value of 1.29, we observed a significantly higher mortality in patients with a relatively high DRR. CONCLUSIONS An elevated DRR was associated with higher 180-day mortality among septic patients, and DRR might be an optimal marker for predicting the long-term mortality of sepsis. More prospective and randomized trials are needed to confirm the prognostic value of DRR.
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15
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Chen S, Huang H, Liu Y, Lai C, Peng S, Zhou L, Chen H, Xu Y, He X. A multi-parametric prognostic model based on clinical features and serological markers predicts overall survival in non-small cell lung cancer patients with chronic hepatitis B viral infection. Cancer Cell Int 2020; 20:555. [PMID: 33292228 PMCID: PMC7678183 DOI: 10.1186/s12935-020-01635-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/29/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To establish and validate a multi-parametric prognostic model based on clinical features and serological markers to estimate the overall survival (OS) in non-small cell lung cancer (NSCLC) patients with chronic hepatitis B viral (HBV) infection. METHODS The prognostic model was established by using Lasso regression analysis in the training cohort. The incremental predictive value of the model compared to traditional TNM staging and clinical treatment for individualized survival was evaluated by the concordance index (C-index), time-dependent ROC (tdROC) curve, and decision curve analysis (DCA). A prognostic model risk score based nomogram for OS was built by combining TNM staging and clinical treatment. Patients were divided into high-risk and low-risk subgroups according to the model risk score. The difference in survival between subgroups was analyzed using Kaplan-Meier survival analysis, and correlations between the prognostic model, TNM staging, and clinical treatment were analysed. RESULTS The C-index of the model for OS is 0.769 in the training cohorts and 0.676 in the validation cohorts, respectively, which is higher than that of TNM staging and clinical treatment. The tdROC curve and DCA show the model have good predictive accuracy and discriminatory power compare to the TNM staging and clinical treatment. The prognostic model risk score based nomogram show some net clinical benefit. According to the model risk score, patients are divided into low-risk and high-risk subgroups. The difference in OS rates is significant in the subgroups. Furthermore, the model show a positive correlation with TNM staging and clinical treatment. CONCLUSIONS The prognostic model showed good performance compared to traditional TNM staging and clinical treatment for estimating the OS in NSCLC (HBV+) patients.
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Affiliation(s)
- Shulin Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Hanqing Huang
- Department of Thoracic Surgery, Maoming People's Hospital, Maoming, 525000, Guangdong, People's Republic of China
| | - Yijun Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Changchun Lai
- Department of Clinical Laboratory, Maoming People's Hospital, Maoming, 525000, Guangdong, People's Republic of China
| | - Songguo Peng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Lei Zhou
- Department of Pathology Laboratory, Maoming People's Hospital, Maoming, 525000, Guangdong, People's Republic of China
| | - Hao Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Yiwei Xu
- Department of Clinical Laboratory, The Cancer Hospital of Shantou University Medical College, Precision Medicine Research Center, Shantou University Medical College, Shantou, 515041, People's Republic of China
| | - Xia He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
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16
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Zhao H, Zhang L, Wu B, Zha Z, Yuan J, Jiang Y, Feng Y. The prognostic value of tumor architecture in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22176. [PMID: 32925787 PMCID: PMC7489711 DOI: 10.1097/md.0000000000022176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND PURPOSE There is a lack of consensus regarding the prognostic value of tumor architecture (sessile vs. papillary) in upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). The aim of the present study was to analyze the current evidence regarding the prognostic role of tumor architecture in patients undergoing RNU for UTUC through a systematic review and meta-analysis. METHODS According to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a literature search in PubMed, Web of Science, Wanfang, and China National Knowledge Infrastructure (CNKI) databases was performed for citations published prior to February 2020. Cumulative analyses of hazard ratios (HRs) and their corresponding 95% confidence intervals (95% CIs) were conducted for the survival outcomes by Stata 12.0 software. RESULTS We retrieved 17 studies (including 8,146 patients) evaluating the effect of tumor architecture on oncologic outcomes in patients treated with RNU. According to our final results, sessile tumor architecture had a significant correlation with worse cancer-specific survival (CSS) (HR = 1.43, 95% CI: 1.31-1.55, P < .001), overall survival (OS) (HR = 1.40, 95% CI: 1.24-1.58, P < .001), recurrence-free survival (RFS) (HR = 1.43, 95% CI: 1.35-1.53, P < .001), and progression-free survival (PFS) (HR = 1.27, 95% CI: 1.11-1.45, P = 0.001). The funnel plot test indicated that there was no significant publication bias in the meta-analysis. Besides, the findings of this study were found to be reliable by our sensitivity and subgroup analysis. CONCLUSIONS Sessile tumor architecture correlates with a significantly worse survival outcome compared with papillary tumor architecture, and it can be used as a valuable biomarker for monitoring prognoses of UTUC patients.
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17
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Su S, Liu L, Li C, Zhang J, Li S. Prognostic Role of Pretreatment De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase Ratio) in Urological Cancers: A Systematic Review and Meta-Analysis. Front Oncol 2020; 10:1650. [PMID: 33014827 PMCID: PMC7498547 DOI: 10.3389/fonc.2020.01650] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/27/2020] [Indexed: 02/04/2023] Open
Abstract
Background: To examine the potential prognostic significance of pretreatment De Ritis ratio (aspartate transaminase/alanine transaminase ratio) in urological cancers, including upper tract urothelial cancer (UTUC), renal cell carcinoma (RCC), prostate cancer (PCa), bladder cancer (BCa). Methods: Potential literatures were searched with PubMed, Embase, Cochrane Library, and Web of Science in December 2019. Merged hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate the associations. Results: Totally, 15 studies with 8,565 patients were included. Merged results showed that an elevated pretreatment De Ritis ratio was correlated with poorer OS (HR 1.80, 95% CI 1.61-2.01), CSS (HR 2.15, 95% CI 1.80-2.56), PFS (HR 1.57, 95% CI 1.34-1.85), BRFS (HR 1.67, 95% CI 1.11-2.53) for urological cancers. Subgroup analyses by cancer type for OS found that De Ritis ratio can be a predictor in UTUC (HR 1.91, 95% CI 1.57-2.33), RCC (HR 1.74, 95% CI 1.47-2.07), and BCa (HR 1.80, 95% CI 1.43-2.27). Similar results could be found for CSS (UTUC: HR 2.46, 95% CI 1.93-3.13; RCC: HR 1.90, 95% CI 1.46-2.47; BCa: HR 2.71, 95% CI 1.39-5.31) and PFS (UTUC: HR 1.59, 95% CI 1.15-2.20; RCC: HR 1.52, 95% CI 1.26-1.83; BCa: HR 1.79, 95% CI 1.18-2.72). There was no publication bias among these included studies. Conclusions: Pretreatment De Ritis ratio was a significant predictor for OS, CSS, PFS and BRFS in urological cancers, indicating that it could be a promising prognostic factor during clinical practice.
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Affiliation(s)
- Shiqiang Su
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Lizhe Liu
- Department of Pathophysiology, Hebei Medical University, Shijiazhuang, China
| | - Chao Li
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Jin Zhang
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Shen Li
- Department of Urology, Shijiazhuang People's Hospital, The No.1 Hospital of Shijiazhuang, Shijiazhuang, China
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18
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Wang J, Li J, Ren Y, Shi H, Rong X, Zhang X, Shao Y, Wu R, Chu M, Qiu H. Association between Alanine Aminotransferase/Aspartate Aminotransferase Ratio (AST/ALT Ratio) and Coronary Artery Injury in Children with Kawasaki Disease. Cardiol Res Pract 2020; 2020:8743548. [PMID: 32274211 PMCID: PMC7125506 DOI: 10.1155/2020/8743548] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 01/06/2020] [Accepted: 01/25/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To investigate the association between the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AST/ALT ratio, AAR) and intravenous immunoglobulin (IVIG) resistance, coronary artery lesions (CAL), and coronary artery aneurysms (CAA) in children with Kawasaki disease (KD). DESIGN We retrospectively studied 2678 children with KD and divided them into two groups: a low-AAR group and a high-AAR group with a median AAR of 1.13 as the cut-off point. The differences in laboratory data, clinical manifestations, and coronary artery damage rates were compared between the two groups. RESULTS The incidence of CAL was higher in the low-AAR group than in the high-AAR group at 2 and 3-4 weeks after illness onset (p < 0.001, respectively). The IVIG resistance rate was significantly higher in the low-AAR group than in the high-AAR group (29.94% vs 21.71%, p < 0.001). The levels of C-reactive protein, erythrocyte sedimentation rate, white blood cell count, bilirubin, fibrinogen, thrombin time, D-dimer, and brain natriuretic peptide were also significantly higher in the low-AAR group compared with the high-AAR group. The levels of albumin and IgG were significantly lower in the low-AAR group compared with those of the high-AAR group. The proportion of typical KD cases in the low-AAR group was significantly higher than that in the high-AAR group. Low-AAR correlated with the risk of coronary artery damage and IVIG resistance. CONCLUSION Children with KD who had low-AAR value were more likely to develop coronary artery damage and IVIG resistance. Low AAR is a risk factor for CAL, CAA, and IVIG resistance in KD.
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Affiliation(s)
- Jinxin Wang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Jiawen Li
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Yue Ren
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Hongying Shi
- Department of Preventive Medicine, School of Public Health and Management, WenZhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Xing Rong
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Xuting Zhang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Yiping Shao
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Rongzhou Wu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Maoping Chu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Huixian Qiu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
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Mori K, Janisch F, Mostafaei H, Kimura S, Lysenko I, Karakiewicz PI, Briganti A, Enikeev DV, Rouprêt M, Margulis V, Chlosta P, Nyirady P, Babjuk M, Egawa S, Shariat SF. Prognostic role of preoperative De Ritis ratio in upper tract urothelial carcinoma treated with nephroureterectomy. Urol Oncol 2020; 38:601.e17-601.e24. [PMID: 32127252 DOI: 10.1016/j.urolonc.2020.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/25/2019] [Accepted: 02/05/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To validate the predictive and prognostic role of the De Ritis ratio in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy in a large multi-institutional cohort. MATERIALS AND METHODS The preoperative De Ritis ratio was assessed in a multi-institutional cohort of 2,492 patients. An altered De Ritis ratio was defined as a ratio >1.35. Logistic regression analyses were performed to assess the association of the De Ritis ratio with advanced disease. The association of the De Ritis ratio with survival outcomes was evaluated using Cox proportional hazards regression models. RESULTS An altered De Ritis ratio was observed in 985 (41.5%) patients; it was associated with a more advanced pathological features. In a preoperative model, the De Ritis ratio was an independent predictive factor for the presence of lymph node metastasis and muscle-invasive and nonorgan-confined disease (P < 0.05). Compared to patients with a normal De Ritis ratio, those with an altered De Ritis ratio had worse recurrence free (P <0.0001), cancer specific (P = 0.0003), and overall survival (P = 0.0014) in the Kaplan-Meier analyses. In the multivariable analyses that was adjusted for the effects of standard clinicopathologic features, the De Ritis ratio did not retain its independent prognostic value. CONCLUSIONS In UTUC, the preoperative De Ritis ratio is associated with adverse clinicopathologic features and independently predicts features of biologically and clinically aggressive UTUC. Therefore, it might be useful to incorporate the De Ritis ratio into prognostic tools in selecting appropriate treatment strategies.
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Affiliation(s)
- Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Florian Janisch
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Hamburg, Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shoji Kimura
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ivan Lysenko
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
| | - Alberto Briganti
- Department of Urology, Vita Salute San Raffaele University, Milan, Italy
| | - Dmitry V Enikeev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Morgan Rouprêt
- Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Urology Department, PARIS, France
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University, Krakow, Poland
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Marek Babjuk
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Urology, Weill Cornell Medical College, New York, NY; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
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Mori K, Janisch F, Mostafaei H, Lysenko I, Kimura S, Egawa S, Shariat SF. Prognostic value of preoperative blood-based biomarkers in upper tract urothelial carcinoma treated with nephroureterectomy: A systematic review and meta-analysis. Urol Oncol 2020; 38:315-333. [PMID: 32088103 DOI: 10.1016/j.urolonc.2020.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE This systematic review and meta-analysis assessed the prognostic value of preoperative blood-based biomarkers in patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy. METHODS PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in June 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared cancer-specific survival in UTUC patients with and without pretreatment laboratory abnormalities. Formal meta-analyses were performed for this outcome. RESULTS The review identified 54 studies with 23,118 patients, of these, 52 studies with 22,513 patients were eligible for the meta-analysis. Several preoperative blood-based biomarkers were significantly associated with cancer-specific survival as follows: neutrophil-lymphocyte ratio (pooled hazard ratio [HR]: 1.66, 95% confidence interval [CI]: 1.34-2.06), C-reactive protein (pooled HR: 1.17, 95% CI: 1.07-1.29), platelet-lymphocyte ratio (pooled HR: 1.68, 95% CI: 1.30-2.17), white blood cell (pooled HR: 1.58, 95% CI: 1.02-2.46), De Ritis ratio (pooled HR: 2.40, 95% CI: 1.92-2.99), fibrinogen (pooled HR: 2.23, 95% CI: 1.86-2.68), albumin-globulin ratio (pooled HR: 3.00, 95% CI: 1.87-4.84), hemoglobin (pooled HR: 1.51, 95% CI: 1.22-1.87), and estimate glomerular filtration rate (pooled HR: 1.52, 95% CI: 1.19-1.94). The Cochrane's Q test and I2 test revealed significant heterogeneity for neutrophil-lymphocyte ratio, C-reactive protein, white blood cell, hemoglobin, and estimated glomerular filtration rate (P = 0.022; I2 = 50.7%, P = 0.000; I2 = 80.4%, P = 0.000; I2 = 88.3%, P = 0.010; I2 = 62.0%, P = 0.000; I2 = 83.9%, respectively). CONCLUSIONS Several pretreatment laboratory abnormalities in patients with UTUC were associated with increased risks of cancer-specific mortality. Therefore, blood-based biomarkers may have the potential to serve as prognostic factors to assist patients and physicians in selecting appropriate treatment strategies for UTUC. However, considering the study limitations including heterogeneity and retrospective nature of the primary data, the conclusions should be interpreted with caution.
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Affiliation(s)
- Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Florian Janisch
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Hamburg, Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ivan Lysenko
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shoji Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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Hu X, Yang WX, Wang Y, Shao YX, Xiong SC, Li X. The prognostic value of De Ritis (AST/ALT) ratio in patients after surgery for urothelial carcinoma: a systematic review and meta-analysis. Cancer Cell Int 2020; 20:39. [PMID: 32042266 PMCID: PMC6998332 DOI: 10.1186/s12935-020-1125-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 01/25/2020] [Indexed: 02/08/2023] Open
Abstract
Background Recently, the De Ritis (AST/ALT) ratio has been considered as a prognostic biomarker for various malignancies. We conducted this systematic review and meta-analysis to explore the prognostic value of preoperative De Ritis ratio in patients after surgery for urothelial carcinoma. Methods We searched the online database Embase, PubMed and Cochrane Library up to October 2019. The hazard ratio (HR) and 95% confidence interval (CI) were extracted from the studies. Results A total of 8 studies incorporating 3949 patients were included in the quantitative synthesis. We observed that elevated preoperative De Ritis ratio is associated with inferior OS (HR = 1.97; 95% CI 1.70–2.28; P < 0.001), CSS (HR = 2.40; 95% CI 2.02–2.86; P < 0.001), RFS (HR = 1.31; 95% CI 1.11–1.54; P = 0.001), PFS (HR = 2.07; 95% CI 1.68–2.56; P < 0.001) and MFS (HR = 2.39; 95% CI 1.16–4.91; P = 0.018). Stratified by diseases, the elevated De Ritis ratio also served as an unfavorable factor. Conclusion The elevated preoperative De Ritis ratio is an unfavorable factor for patients with urothelial carcinoma. In patients with BC and UTUC, the elevated preoperative De Ritis ratio is also associated with poor prognosis. But De Ritis ratio must be validated in large, independent cohorts before it can be applied widely.
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Affiliation(s)
- Xu Hu
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Wei-Xiao Yang
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Yan Wang
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Yan-Xiang Shao
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - San-Chao Xiong
- 1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041 People's Republic of China
| | - Xiang Li
- 2Department of Urology, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Street, Chengdu, 610041 People's Republic of China
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Ikeda T, Ishihara H, Takagi T, Fukuda H, Yoshida K, Iizuka J, Kobayashi H, Okumi M, Ishida H, Kondo T, Tanabe K. The De Ritis (Aspartate Transaminase/Alanine Transaminase) Ratio as a Prognosticator in Patients With End-stage Renal Disease-associated Renal Cell Carcinoma. Clin Genitourin Cancer 2019; 18:236-240.e1. [PMID: 31917171 DOI: 10.1016/j.clgc.2019.12.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The aspartate transaminase (AST)/alanine transaminase (ALT) ratio (ie, the De Ritis ratio) is associated with prognosis in some types of cancers including renal cell carcinoma (RCC). Meanwhile, an effective prognosticator for end-stage renal disease (ESRD)-associated RCC remains unknown. Thus, we investigated the prognostic impact of the AST/ALT ratio in patients with ESRD-associated RCC. PATIENTS AND METHODS We retrospectively evaluated 243 patients receiving radical nephrectomy for nonmetastatic ESRD-associated RCC. The patients were divided according to the cutoff value of preoperative AST/ALT ratio. Prognostic factors associated with cancer-specific survival (CSS) after radical nephrectomy were analyzed. RESULTS The maximum Youden index showed that the cutoff value of the AST/ALT ratio was 1.42. The high AST/ALT ratio group (≥ 1.42; n = 88) had a significantly shorter 10-year CSS than the low AST/ALT ratio group (64.3% vs. 87.2%; P = .0027). Multivariate analysis revealed that the AST/ALT ratio was an independent prognostic factor of CSS (hazard ratio [HR], 3.03; P = .0020), together with serum C-reactive protein level (HR, 4.84; P < .0001), pathologic stage (HR, 2.79; P = .0030), and tumor grade (HR, 7.08; P = .0087). Based on these independent factors, the patients were further classified into 3 groups: low (0-1 factor), intermediate (2 factors), and high risk (3-4 factors). The 10-year CSS in the high-risk group was significantly shorter than that of the other groups (68.9% vs. 70.9% vs. 94.4%; P < .0001). CONCLUSION The AST/ALT ratio can aid in the risk classification of patients with ESRD-associated RCC.
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Affiliation(s)
- Takashi Ikeda
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroki Ishihara
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
| | - Toshio Takagi
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hironori Fukuda
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazuhiko Yoshida
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Junpei Iizuka
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Masayoshi Okumi
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hideki Ishida
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tsunenori Kondo
- Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Kazunari Tanabe
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
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Cao Y, Chen G, Li H, Liu Y, Tao Z, Li L, Chen W, Xu Y, Chen X. De Ritis ratio as a significant prognostic factor of international normalized ratio ≥4 in the initial 10 days of warfarin therapy. Biomark Med 2019; 13:1599-1607. [PMID: 31660758 DOI: 10.2217/bmm-2019-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the relationship between the De Ritis ratio on admission and warfarin sensitivity in the initial 10 days of anticoagulation therapy. Methods: We retrospectively reviewed data from 906 patients who underwent heart valve replacement surgery. Results: A De Ritis ratio of 1.19 was identified as the optimal cutoff according to the ROC curve. Patients with a high De Ritis ratio achieved an international normalized ratio (INR) ≥4 more easily and earlier than those with a low De Ritis ratio in the initial 10 days of warfarin therapy. Multivariate analysis showed that a high De Ritis ratio was an independent predictor of an INR ≥4 (HR: 2.567; p < 0.001). Conclusion: A De Ritis ratio ≥1.19 on admission was significantly associated with an INR ≥4 in the initial 10 days of warfarin therapy among patients underwent heart valve replacement surgery.
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Affiliation(s)
- Yide Cao
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Ganyi Chen
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Huangshu Li
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Yafeng Liu
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Zhonghao Tao
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Liangpeng Li
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Wen Chen
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Yueyue Xu
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
| | - Xin Chen
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, PR China
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De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase) as a Significant Prognostic Factor in Patients Undergoing Radical Cystectomy with Bladder Urothelial Carcinoma: A Propensity Score-Matched Study. DISEASE MARKERS 2019; 2019:6702964. [PMID: 31534562 PMCID: PMC6732616 DOI: 10.1155/2019/6702964] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/07/2019] [Indexed: 01/09/2023]
Abstract
Introduction To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase (AST)/alanine transaminase (ALT)) and postoperative outcome in patients with urothelial cell carcinoma (UC) treated with radical cystectomy. Materials and Methods We analyzed the clinical and pathological data of 771 patients who underwent radical cystectomy for bladder UC. Patients were divided into two groups according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed using the Kaplan–Meier method and Cox regression hazard models for patients' cancer-specific survival (CSS), overall survival (OS), and recurrence-free survival (RFS). In addition, propensity score matching of 1 : 1 was performed between the two groups. Results Median follow-up was 84.0 (36–275) months. Mean age was 64.8 ± 10.0 years. According to the receiver operating characteristic (ROC) analysis, the optimal threshold of the AST/ALT ratio was 1.1. In Kaplan–Meier analyses, the high AST/ALT group showed worse outcomes in CSS and OS (all P < 0.001). Also, RFS (P = 0.001) in the Cox regression models of clinical and pathological parameters was used to predict CSS, OS, and AST/ALT ratio (HR 2.15, 95% CI 1.23-3.73, P = 0.007) and pathological T stage (HR 4.80, 95% CI 1.19-19.28, P = 0.003). To predict OS and AST/ALT ratio (HR 2.05, 95% CI 1.65–2.56, P < 0.001), pathological T stage (HR 2.96, 95% CI 0.57–17.09, P = 0.037) and positive lymph node (HR 1.71, 95% CI 1.50–1.91, P = 0.021) were determined as independent prognostic factors. Conclusion Preoperative AST/ALT ratio could be an independent prognostic factor in patients with UC treated with radical cystectomy.
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Fukui S, Miyake M, Iida K, Onishi K, Hori S, Morizawa Y, Kagebayashi Y, Fujimoto K. The Preoperative Predictive Factors for Pathological T3a Upstaging of Clinical T1 Renal Cell Carcinoma. Diagnostics (Basel) 2019; 9:diagnostics9030076. [PMID: 31311108 PMCID: PMC6787604 DOI: 10.3390/diagnostics9030076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/13/2019] [Accepted: 07/14/2019] [Indexed: 12/15/2022] Open
Abstract
We aimed to determine the oncological outcomes of patients with clinical T1 renal cell carcinoma (RCC) upstaged to pathological T3a and to identify the preoperative predictive factors for upstaging. We retrospectively reviewed 272 patients with clinical T1 RCC who underwent surgical treatment. Thirty-three patients (12%) were upstaged to pathological T3a. These patients had a significantly larger tumor size on computed tomography (p < 0.0001), a higher aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (p = 0.037), and an elevated c-reactive protein (CRP) level (p = 0.014) preoperatively compared with those with pathological T1 RCC. On multivariate analysis, tumor diameter was the only significant preoperative predictive factor for upstaging [hazard ratio (HR), 3.61; 95% confidence interval (CI), 1.32-9.84; p = 0.01]. The AST/ALT ratio tended to be a preoperative predictive factor for upstaging, although it was not significant (HR, 2.14; 95% CI, 0.97-4.73; p = 0.06). Pathological T3a upstaging occurred in 25% of those with a tumor diameter ≥30 mm and a preoperative AST/ALT ratio ≥1.1. There was a significant correlation between pathological T3a upstaging and the number of preoperative risk factors (p = 0.0002). The preoperative tumor diameter and serum AST/ALT ratio can be predictive factors for pathological T3a upstaging in patients with clinical T1 RCC.
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Affiliation(s)
- Shinji Fukui
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan.
| | - Makito Miyake
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Kota Iida
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Kenta Onishi
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Yoriaki Kagebayashi
- Department of Urology, Nara Prefecture General Medical Center, 897-5, Shichijo-nishi machi 2 chome, Nara, Nara 630-8581, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
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Wu J, Chen L, Wang Y, Tan W, Huang Z. Prognostic value of aspartate transaminase to alanine transaminase (De Ritis) ratio in solid tumors: a pooled analysis of 9,400 patients. Onco Targets Ther 2019; 12:5201-5213. [PMID: 31308692 PMCID: PMC6612963 DOI: 10.2147/ott.s204403] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/18/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Numerous studies have reported the association between pretreatment serum aspartate transaminase to alanine transaminase (AST/ALT) ratio and prognosis in multiple cancers. However, the results remain controversial and no consensus has been reached. Thus, we conducted this meta-analysis to quantitatively assess the prognostic value of pretreatment AST/ALT ratio in solid tumors. METHODS A systematic literature search was conducted by using PubMed, EMBASE, Web of Science, Cochrane Library, and Wanfang databases, as well as several trial registry platforms, including ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and Chinese Clinical Trial Registry, up to April 5, 2019. HR and 95% CI for overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were calculated to estimate the effect size. RESULTS A total of 18 studies with 9,400 patients were included. Overall, a high level of pretreatment AST/ALT ratio was significantly associated with worse OS (pooled HR=1.70, 95% CI=1.38-2.09). The statistical significance was observed in all cancer types, including renal cell carcinoma (pooled HR=1.64, 95% CI=1.30-2.05), liver cancer (pooled HR=1.16, 95% CI=1.04-1.29), urinary tract urothelial carcinoma (pooled HR=1.96, 95% CI=1.53-2.51), bladder cancer (pooled HR =2.66, 95% CI=1.69-4.20), and other cancers (pooled HR=1.44, 95% CI=1.18-1.76). Moreover, an increased level of serum AST/ALT ratio predicted unfavorable CSS (pooled HR=2.07, 95% CI=1.74-2.46) and RFS (pooled HR=1.51, 95% CI=1.15-1.99). CONCLUSION Elevated level of serum AST/ALT ratio before treatment is significantly associated with poor clinical outcomes of OS, CSS, and RFS in patients with solid tumors. Pretreatment AST/ALT ratio can serve as a useful prognostic predictor for malignant patients.
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Affiliation(s)
- Jiayuan Wu
- Clinical Research Center, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
| | - Lin Chen
- Department of Cardiac Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
| | - Yufeng Wang
- School of Public Health, Guangdong Medical University, Zhanjiang524023, Guangdong Province, People’s Republic of China
| | - Wenkai Tan
- Department of Gastroenterology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
| | - Zhe Huang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong Province, People’s Republic of China
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Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma. BMC Cancer 2019; 19:553. [PMID: 31176361 PMCID: PMC6556027 DOI: 10.1186/s12885-019-5758-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 05/27/2019] [Indexed: 12/22/2022] Open
Abstract
Background Liver function is routinely assessed in clinical practice as liver function tests provide sensitive indicators of hepatocellular injury. However, the prognostic value of enzymes that indicate hepatic injury has never been systematically investigated in lymphoma, including diffuse large B-cell lymphoma (DLBCL). Methods This study examined the prognostic value of baseline aspartic transaminase (AST) in DLBCL patients. The association between AST and clinical features was analyzed in 179 DLBCL patients treated from 2006 to 2016. All enrolled patients were treated with R-CHOP or R-CHOP-like chemotherapy. Log-rank test, univariable analysis, and subgroup analysis were performed to evaluate the impact of AST on survival. Results AST 33.3 U/L was considered to be the optimal threshold value for predicting prognosis. A higher AST level was associated with advanced stage (P = 0.001), poorer performance status (P = 0.014), elevated lactate dehydrogenase level (P < 0.0001), presence of B symptoms (P = 0.001), high-risk International Prognostic Index (IPI, IPI 3–5) (P = 0.002), non-germinal center B-cell subtypes (P = 0.038), hepatitis B virus surface antigen positivity (P = 0.045) and more extra nodal involvement (ENI, ENI ≥ 2) (P = 0.027). Patients with a higher AST level had a shorter overall survival (OS) (2-year OS rate, 53.6% vs. 83.6%, P < 0.001). Subgroup analysis indicated that higher AST levels have poorer prognostic values in patients without B symptoms and LDH positive groups. Conclusion A pretreatment AST level is associated with OS in DLBCL patients treated with R-CHOP or similar chemotherapy regimens. A high pretreatment AST level might be a reliable prognostic factor for predicting a dismal outcome in DLBCL patients. Serum AST levels may be investigated for use as an easily determinable, inexpensive biomarker for risk assessment in patients with DLBCL. Electronic supplementary material The online version of this article (10.1186/s12885-019-5758-2) contains supplementary material, which is available to authorized users.
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Li T, Xu H, Yang L, Tan P, Wei Q. Predictive value of preoperative lymphocyte-to-monocyte ratio for patients with upper tract urothelial carcinoma. Clin Chim Acta 2019; 492:50-56. [DOI: 10.1016/j.cca.2019.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 01/18/2019] [Accepted: 02/10/2019] [Indexed: 12/20/2022]
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Li Y, Fang D, Bao Z, He A, Guan B, He S, Zhan Y, Gong Y, Li X, Zhou L. High aspartate transaminase/alanine transaminase ratio predicts poor prognosis in patients with localized upper tract urothelial cancer: a propensity score-matched study in a large Chinese center. Onco Targets Ther 2019; 12:2635-2648. [PMID: 31114222 PMCID: PMC6489587 DOI: 10.2147/ott.s193771] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/17/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the prognostic value of the aspartate transaminase/alanine transaminase (AST/ALT) ratio in a large Chinese cohort surgically treated for localized upper tract urothelial carcinoma (UTUC) using propensity score matching (PSM) analysis. Methods: Data of 908 consecutive patients with localized UTUC who underwent radical nephroureterectomy (RNU) were retrospectively evaluated. The endpoints of prognosis were progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) after RNU. We compared these endpoints according to the AST/ALT ratio before and after 1:1 PSM. The independent predictors for PFS, CSS and OS were also analyzed. Results: A high AST/ALT ratio was correlated with unfavorable factors, including elderly age, female gender, history of coronary disease, alcohol and tobacco consumption, lower body mass index, and larger tumor volume. Before PSM, the Kaplan–Meier curves showed significantly poorer survival outcomes in PFS, CSS, and OS (all P<0.001) for patients with high AST/ALT ratios. After PSM, the high AST/ALT ratio group also had significantly inferior survival outcomes in terms of PFS, OS and CSS (all P<0.001). Furthermore, multivariate analyses revealed that the AST/ALT ratio was an independent predictor for PFS, CSS and OS before PSM (PFS hazard ratio [HR] 1.454, P=0.001; CSS HR 2.577, P<0.001; OS HR 1.925, P<0.001) and after PSM (PFS HR 1.711, P<0.001; CSS HR 2.588, P<0.001; OS HR 1.957, P<0.001). Conclusion: The preoperative AST/ALT ratio can be a convenient and useful prognostic biomarker for patients with localized UTUC.
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Affiliation(s)
- Yifan Li
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Dong Fang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Zhengqing Bao
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Anbang He
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Bao Guan
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Shiming He
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Yonghao Zhan
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Yanqing Gong
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Urological Cancer Center, Beijing 100034, People's Republic of China
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Canat L, Ataly HA, Agalarov S, Alkan I, Altunrende F. The effect of AST/ALT (De Ritis) ratio on survival and its relation to tumor histopathological variables in patients with localized renal cell carcinoma. Int Braz J Urol 2018; 44:288-295. [PMID: 29211398 PMCID: PMC6050548 DOI: 10.1590/s1677-5538.ibju.2017.0173] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 06/17/2017] [Indexed: 12/28/2022] Open
Abstract
Purpose To 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 Methods We 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. Results An 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. Conclusion An 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.
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Affiliation(s)
- Lütfi Canat
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Hasan Anil Ataly
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Samir Agalarov
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Ilter Alkan
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Fatih Altunrende
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
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Gorgel SN, Kose O, Koc EM, Ates E, Akin Y, Yilmaz Y. The prognostic significance of preoperatively assessed AST/ALT (De Ritis) ratio on survival in patients underwent radical cystectomy. Int Urol Nephrol 2017; 49:1577-1583. [DOI: 10.1007/s11255-017-1648-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 06/29/2017] [Indexed: 12/18/2022]
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Wang H, Fang K, Zhang J, Jiang Y, Wang G, Zhang H, Chen T, Shi X, Li Y, Duan F, Liu J. The significance of De Ritis (aspartate transaminase/alanine transaminase) ratio in predicting pathological outcomes and prognosis in localized prostate cancer patients. Int Urol Nephrol 2017; 49:1391-1398. [PMID: 28550473 DOI: 10.1007/s11255-017-1618-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/12/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE To illustrate whether De Ritis (aspartate transaminase-AST/alanine transaminase-ALT) ratio is useful in risk stratification of localized prostate cancer and propose an easy predictive model for biochemical recurrence-free survival (BCRFS). METHODS In total, 438 patients who underwent radical prostatectomy were included in this study. Blood samples including AST and ALT were collected 1-7 days before surgery. An elevated AST and ALT value was defined as over 40 or 56 IU/L. RESULTS The median AST and ALT value was 18.5 (16-22) and 14 (11-18) IU/L. In total, 15 patients (3.4%) and 9 patients (2.1%) exhibited elevated AST value and ALT value. The median De Ritis ratio was 1.33 (1.11-1.60), and ROC curve indicated the best cutoff of 1.325 in predicting the occurrence of biochemical recurrence. Higher De Ritis ratio was found to be related to older age (p < 0.001), higher tumor stages (p < 0.001) and Gleason Score (p < 0.001), presence of seminal invasion (p < 0.001), positive surgical margin (p < 0.001) and lymph node metastasis (p = 0.003). Multivariate logistic regression confirmed that De Ritis ratio was an independent predictor for final Gleason Score (p < 0.001), and multivariate Cox regression demonstrated De Ritis ratio as an independent risk factor for BCRFS. A simple predictive model which incorporated De Ritis ratio, pathological tumor stage and final Gleason Score could help risk stratification for BCRFS. CONCLUSION Higher De Ritis ratio could be predictive for worse pathological outcomes and higher BCR in localized prostate cancer patients. A predictive model which incorporates De Ritis ratio, Gleason Score and pathological tumor stage could help risk stratification for BCRFS.
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Affiliation(s)
- Huitao Wang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Kewei Fang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Jinsong Zhang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Yongming Jiang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Guang Wang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Haiyan Zhang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Tao Chen
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Xin Shi
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Yuhang Li
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Fei Duan
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China
| | - Jianhe Liu
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao Road, Kunming, 650101, Yunnan, People's Republic of China.
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Cho YH, Hwang JE, Chung HS, Kim MS, Hwang EC, Jung SI, Kang TW, Kwon DD, Choi SH, Kim HT, Kim TH, Kwon TG, Noh JH, Kim MK, Kim CS, Kang SG, Kang SH, Cheon J, Lee CH, Ku JY, Ha HK, Tae BS, Jeong CW, Ku JH, Kwak C, Kim HH. The De Ritis (aspartate transaminase/alanine transaminase) ratio as a predictor of oncological outcomes in patients after surgery for upper urinary tract urothelial carcinoma. Int Urol Nephrol 2017; 49:1383-1390. [PMID: 28484945 DOI: 10.1007/s11255-017-1613-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/02/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE Recently, several studies have shown that the De Ritis ratio (aspartate transaminase/alanine transaminase) can be a useful prognostic biomarker for certain types of malignant tumors. However, the prognostic value of the De Ritis ratio in patients with upper tract urothelial carcinoma remains largely unknown. The aim of the present study was to evaluate the prognostic significance of the De Ritis ratio in patients who had undergone radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma. METHODS In total, 1049 patients who underwent RNU at eight institutions from 2004 to 2015 were reviewed retrospectively. The De Ritis ratio and conventional clinicopathological parameters were analyzed. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Multivariate analysis was carried out using the Cox proportional hazards regression model. De Ritis ratio cutoff values were derived from receiver operating characteristic (ROC) curves. RESULTS ROC analysis showed the cutoff De Ritis ratio for overall death to be 1.6 (p = 0.002). The cancer-specific survival (CSS) and overall survival (OS) were significantly shorter for patients with a high De Ritis ratio (>1.6). Multivariate analysis revealed an independent relationship between an increased De Ritis ratio (>1.6) and shorter CSS (hazard ratio, HR 2.49, 95% confidence interval, CI 1.70-3.64; p = 0.001) and OS (HR 1.84, 95% CI 1.34-2.52; p = 0.001). CONCLUSION The De Ritis ratio can be a significant predictor of oncological outcomes in patients with upper urinary tract urothelial carcinoma after surgery.
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Affiliation(s)
- Yang Hyun Cho
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Jun Eul Hwang
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Myung Soo Kim
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea.
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Taek Won Kang
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea
| | - Seock Hwan Choi
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Tae Kim
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae-Hwan Kim
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Joon Hwa Noh
- Department of Urology, Kwangju Christian Hospital, Gwangju, Korea
| | - Myung Ki Kim
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - Chul-Sung Kim
- Department of Urology, Chosun University School of Medicine, Gwangju, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Chan Ho Lee
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Ja Yoon Ku
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Hong Koo Ha
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Bum Sik Tae
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
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Gao F, Chen C, Lu J, Zheng J, Ma XC, Yuan XY, Huo K, Han JF. De Ritis ratio (AST/ALT) as an independent predictor of poor outcome in patients with acute ischemic stroke. Neuropsychiatr Dis Treat 2017; 13:1551-1557. [PMID: 28670124 PMCID: PMC5478276 DOI: 10.2147/ndt.s139316] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The aspartate transaminase/alanine transaminase ratio (De Ritis ratio, AAR) was reported to be associated with patients' prognosis in certain diseases recently. The objective of the current study was to determine the association between the AAR at admission and poor outcome at 3 months in acute ischemic stroke (AIS) patients. PATIENTS AND METHODS This retrospective cohort study included patients who experienced their first-ever AIS between June 2015 and March 2016. The primary outcome measure was a poor outcome at 3 months (modified Rankin Scale score >2). Multivariate logistic regression models were used to assess the relationship between AAR quartiles and clinical outcomes among the AIS patients. Receiver operating characteristic curve analysis was applied to identify the optimal cutoff for AAR in predicting the prognosis of AIS. RESULTS In terms of the relationship between poor outcome and AAR, the adjusted odds ratio comparing the highest and lowest AAR quartiles was 2.15 (95% confidence interval =1.14-4.05). An AAR of 1.53 was identified as the optimal cutoff. In a prespecified subgroup analysis according to the time from symptom onset to treatment (>24 vs ≤24 hours), there was no significant difference in the effect of AAR >1.53 between the two groups. CONCLUSION An increased AAR at admission is significantly associated with a poor outcome at 3 months in AIS patients.
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Affiliation(s)
| | | | | | | | - Xian-Cang Ma
- Clinical Research Center.,Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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