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Velaer K, Thomas IC, Yang J, Kapphahn K, Metzner TJ, Golla A, Hoerner CR, Fan AC, Master V, Chertow GM, Brooks JD, Patel CJ, Desai M, Leppert JT. Clinical laboratory tests associated with survival in patients with metastatic renal cell carcinoma: A Laboratory Wide Association Study (LWAS). Urol Oncol 2021; 40:12.e23-12.e30. [PMID: 34580027 DOI: 10.1016/j.urolonc.2021.08.011] [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: 04/12/2021] [Revised: 08/03/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prognostic models for patients with metastatic renal cell carcinoma (mRCC) include select laboratory values. These models have important limitations, including reliance on a limited array of laboratory tests, and use of dichotomous ("high-low") cutoffs. We applied a Laboratory-Wide Association Study (LWAS) framework to systematically evaluate common clinical laboratory results associated with survival for patients diagnosed with mRCC. METHODS We used laboratory data for 3,385 patients diagnosed with mRCC from 2002 to 2017. We developed a LWAS framework, to examine the association with 53 common clinical laboratory tests results (641,712 measurements) and overall survival. We employed false-discovery rate to test the association of multiple laboratory tests with survival, and validated these results using 3 separate cohorts to generate a standardized hazard ratio (sHR), reported for a 1 standard deviation unit change in each laboratory test. RESULTS The LWAS approach confirmed the association of laboratory values currently used in prognostic models with survival, including calcium (HR 1.35, 95%CI 1.24-1.48), leukocyte count (HR 1.40, 95%CI 1.30-1.51), platelet count (HR 1.36, 95%CI 1.27-1.51), and hemoglobin (HR 0.79, 95%CI 0.72-0.86). Use of these tests as continuous variables improved model performance. LWAS also identified acute phase reactants associated with survival not typically included in prognostic models, including serum albumin (HR 0.66, 95%CI 0.61-0.72), ferritin (HR 1.25, 95%CI 1.08-1.45), alkaline phosphatase (HR 1.31, 95%CI 1.23-1.40), and C-reactive protein (HR 1.70, 95%CI 1.14-2.53). CONCLUSIONS Routinely measured laboratory tests can refine current prognostic models, facilitate comparisons across clinical trial cohorts, and match patients with specific systemic therapies.
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Affiliation(s)
- Kyla Velaer
- Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - I-Chun Thomas
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jaden Yang
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Kristopher Kapphahn
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Thomas J Metzner
- Department of Urology, Stanford University School of Medicine, Stanford, CA; Pacific Northwest University of Health Sciences, Yakima, WA
| | - Abhinav Golla
- Department of Ophthalmology, UCLA School of Medicine, Los Angeles, CA
| | - Christian R Hoerner
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Alice C Fan
- Department of Urology, Stanford University School of Medicine, Stanford, CA; Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Viraj Master
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Glenn M Chertow
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - James D Brooks
- Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA
| | - Manisha Desai
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - John T Leppert
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Department of Urology, Stanford University School of Medicine, Stanford, CA; Department of Medicine, Stanford University School of Medicine, Stanford, CA.
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Gad El-Hak HN, Abdelrazek HMA, Zeidan DW, Almallah AA, Khaled HE. Assessment of changes in the liver of pregnant female rats and their fetuses following monosodium glutamate administration. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:44432-44441. [PMID: 33847887 DOI: 10.1007/s11356-021-13557-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
Monosodium glutamate (MSG) is a common flavor enhancer and stabilizer for ready-made or packaged foods. This research investigated the impact of MSG on the maternal and fetal liver. The present study was carried out on sixteen mature female Albino rats and eight male rats of reproductive age. The control group was dissected on day 20 of gestation. MSG group was administrated MSG daily at a dosage of 1 g/5 mL/kg body weight from day 0 to day 20 of gestation. The liver function and lipid profile of the control and treated mothers were investigated in the blood sera. The levels of nitric oxide (NO), tumor necrosis factor (TNF-α), superoxide dismutase (SOD), and reduced glutathione (GSH) activities in the liver homogenate of maternal and fetal tissue were assayed, in addition to histopathological, histochemical and immunohistochemical studies were done to the liver tissue. The activities of liver functions and lipid profile significantly altered in the treated mothers with MSG. MSG significantly reduced the SOD and reduced GSH activities in addition to the elevated TNF-α and NO in liver tissue of pregnant mothers and their fetuses. Severe histopathological alterations were observed in both maternal and fetal liver tissues of MSG-treated groups. Moreover, histochemical observations showed a reduction of total polysaccharides in the liver of pregnant rats and fetuses. A significant increase in the percentage area of positive immunoreaction for caspase 3 was observed in the liver of treated rats with MSG compared to the liver of the control. The liver of fetuses treated with MSG revealed an alteration like their mother. This study showed that during the gestational period MSG exposure resulted in several biochemical, histological, and histochemical changes in the maternal and fetal liver tissues which emphasize the toxic effect of MSG.
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Affiliation(s)
- Heba N Gad El-Hak
- Zoology Department, Faculty of Sciences, Suez Canal University, Ismailia, Egypt.
| | - Heba M A Abdelrazek
- Department of Physiology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Dalia W Zeidan
- Department of Home and Economics, Nutrition and Food Science Branch, Faculty of Education, Suez Canal University, Ismailia, Egypt
| | - Amani A Almallah
- Department of Anatomy and Embryology, Faculty of Medicine, Suez University, Ismailia, Egypt
| | - Howayda E Khaled
- Zoology Department, Faculty of Sciences, Suez University, Ismailia, Egypt
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A Systematic Review of Serum γ-Glutamyltransferase as a Prognostic Biomarker in Patients with Genitourinary Cancer. Antioxidants (Basel) 2021; 10:antiox10040549. [PMID: 33916150 PMCID: PMC8066142 DOI: 10.3390/antiox10040549] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
γ-Glutamyltransferase (GGT), a membrane-bound enzyme, contributes to the metabolism of glutathione (GSH), which plays a critical physiological role in protecting cells against oxidative stress. GGT has been proposed as a biomarker of carcinogenesis and tumor progression given that GGT activity is important during both the promotion and invasion phases in cancer cells. Moreover, GGT expression is reportedly related to drug-resistance possibly because a wide range of drugs are conjugated with GSH, the availability of which is influenced by GGT activity. While serum GGT activity is commonly used as a quick, inexpensive, yet reliable means of assessing liver function, recent epidemiological studies have shown that it may also be an indicator of an increased risk of prostate cancer development. Moreover, elevated serum GGT is reportedly an adverse prognostic predictor in patients with urologic neoplasms, including renal cell carcinoma, prostate cancer, and urothelial carcinoma, although the background mechanisms have still not been well-characterized. The present review article summarizes the possible role of GGT in cancer cells and focuses on evidence evaluation through a systematic review of the latest literature on the prognostic role of serum GGT in patients with genitourinary cancer.
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Takemura K, Yuasa T, Inamura K, Amori G, Koga F, Board PG, Yonese J. Impact of Serum γ-Glutamyltransferase on Overall Survival in Patients with Metastatic Renal Cell Carcinoma in the Era of Targeted Therapy. Target Oncol 2021; 15:347-356. [PMID: 32474759 DOI: 10.1007/s11523-020-00719-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND γ-Glutamyltransferase (GGT) is a marker of oxidative stress. Elevated serum GGT is linked to poor survival in various malignancies; however, there are no data on metastatic renal cell carcinoma (mRCC). Additionally, GGT expression in cancer tissues remains largely unknown. OBJECTIVE The present study was designed to determine the prognostic role of serum GGT in patients with mRCC and the association between systemic and local GGT levels. PATIENTS AND METHODS Pretherapeutic serum GGT and other clinicopathological parameters were retrospectively compared with overall survival (OS) in 146 consecutive patients with mRCC receiving tyrosine kinase inhibitor therapy. GGT expression was analyzed in 65 resected specimens using immunohistochemistry. RESULTS A total of 82 patients (56%) died during the follow-up period (median 34.9 months). Median OS was 16.0 months and 36.8 months in patients with elevated GGT levels and without elevated GGT, respectively (P < 0.001). On multivariable analysis, elevated serum GGT was an independent adverse prognostic factor (hazard ratio [HR] 4.04, P < 0.001), together with high neutrophils (HR 2.06, P = 0.041), low albumin (HR 2.00, P = 0.006), high lactate dehydrogenase (HR 2.68, P < 0.001), and high De Ritis ratio (HR 1.97, P = 0.004). Preoperative serum GGT levels were 29, 48, and 109 U/l in patients whose renal cancer cells showed negative to weak, moderate, and strong GGT expression, respectively (P = 0.004). CONCLUSIONS Elevated serum GGT was an unfavorable prognostic factor in mRCC, and overexpression of GGT in renal cancer cells might be responsible for elevation of serum GGT.
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Affiliation(s)
- Kosuke Takemura
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. .,Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kentaro Inamura
- Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Gulanbar Amori
- Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Fumitaka Koga
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Philip G Board
- ACRF Department of Cancer Biology and Therapeutics, Group of Molecular Genetics, John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Ishiyama Y, Kondo T, Tachibana H, Ishihara H, Fukuda H, Yoshida K, Takagi T, Iizuka J, Tanabe K. Predictive role of γ-glutamyltransferase in patients receiving nivolumab therapy for metastatic renal cell carcinoma. Int J Clin Oncol 2020; 26:552-561. [PMID: 33135126 DOI: 10.1007/s10147-020-01819-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 10/18/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION γ-Glutamyltransferase is reportedly associated with survival in local and metastatic renal cell carcinoma patients; however, its predictive role among patients treated with immune-checkpoint inhibitors are unknown. This study aimed to investigate the role of γ-glutamyltransferase as a predictive marker among metastatic renal cell carcinoma patients undergoing nivolumab therapy. METHODS We retrospectively evaluated 69 nivolumab-treated metastatic renal cell carcinoma patients upon failure of one or more systematic therapies. Serum γ-glutamyltransferase levels were determined at baseline and 2 months after nivolumab treatment initiation. Patients were classified as high (≥ 49 U/L) and low (< 49 mg/dL) from baseline GGT levels and the outcomes were compared between the two groups. Furthermore, increased (after/baseline ≥ 2) and non-increased (after/baseline < 2) groups were compared. Progression-free survival and overall survival were evaluated after nivolumab initiation. RESULTS Overall survival was significantly shorter in the high baseline γ-glutamyltransferase group (20.3%) than in the low group (79.7%) (median 2.33 vs not reached [months], p = 0.0051). Progression-free survival and the overall survival were significantly shorter in the increased than in the non-increased group (24.6% and 75.4%, respectively) (median PFS: 4.43 vs 7.23 [months], p = 0.0373/OS: 24.00 vs not reached, p = 0.0467). On multivariate analyses, high baseline γ-glutamyltransferase was an independent factor for overall survival (p = 0.0345) and increased γ-glutamyltransferase was an independent factor for progression-free survival (p = 0.0276) and overall survival (p = 0.0160). CONCLUSIONS High baseline γ-glutamyltransferase and its early increase are associated with a poor prognosis in metastatic renal cell carcinoma patients receiving nivolumab. Serum γ-glutamyltransferase levels may help predict treatment outcomes.
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Affiliation(s)
- Yudai Ishiyama
- Department of Urology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.,Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Tsunenori Kondo
- Department of Urology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.
| | - Hidekazu Tachibana
- Department of Urology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Hiroki Ishihara
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Hironori Fukuda
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Kazuhiko Yoshida
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Toshio Takagi
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Junpei Iizuka
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Kazunari Tanabe
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan
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Guo J, Liu S, Gao S, Kou F, Zhang X, Liu P, Yang R, Zhu X. γ-Glutamyltranspeptidase as a Prognostic Biomarker in Advanced Hepatocellular Carcinoma Treated with Transarterial Chemoembolization. J Vasc Interv Radiol 2020; 32:419-428.e2. [PMID: 33067120 DOI: 10.1016/j.jvir.2020.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/24/2020] [Accepted: 07/10/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To evaluate the prognostic value of pretreatment serum γ-glutamyltransferase (GGT) level in patients with advanced hepatocellular carcinoma (HCC) receiving transarterial chemoembolization. MATERIALS AND METHODS This retrospective study included 140 patients (123 male, 17 female; mean age, 56.9 y ± 12.0; range, 22.0-82.0 y) with Barcelona Clinic Liver Cancer class C HCC who received first-line conventional chemoembolization between December 2013 and March 2018. Patients were divided into low and high GGT groups based on a cutoff value calculated with a receiver operating characteristic curve. Overall survival (OS) was compared between groups by log-rank test. Univariate and multivariate survival analyses were performed. RESULTS The optimal cutoff values of GGT were 119.5 U/L in men and 175.0 U/L in women. The 6-, 9-, and 12-mo OS rates were 81.7%, 72.4%, and 62.9%, respectively, for patients in the low GGT group (n = 44) and 58.8%, 35.7%, and 28.8%, respectively, for patients in the high GGT group (n = 96; P < .001). Multivariable Cox regression analysis identified high pretreatment serum GGT level (hazard ratio [HR], 2.71; 95% confidence interval [CI], 1.67-4.40; P < .001), multiple tumors (HR, 3.05; 95% CI, 1.23-7.53; P = .02), and performance of target treatment (ie, sorafenib; HR, 0.41; 95% CI, 0.24-0.72; P = .002) or ablation (HR, 0.35; 95% CI, 0.18-0.66; P = .001) as independent prognostic factors for OS. CONCLUSIONS Pretreatment serum GGT level was an independent prognostic factor for OS in patients with advanced HCC treated with chemoembolization, suggesting that GGT is a useful prognostic biomarker for advanced HCC.
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Affiliation(s)
- Jianhai Guo
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China
| | - Shaoxing Liu
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China
| | - Song Gao
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China
| | - Fuxin Kou
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China
| | - Xin Zhang
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China
| | - Peng Liu
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China
| | - Renjie Yang
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China
| | - Xu Zhu
- Department of Interventional therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd., Haidian District, Beijing 100142, China.
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Horie K, Kawakami K, Fujita Y, Matsuda Y, Arai T, Suzui N, Miyazaki T, Koie T, Mizutani K, Ito M. Serum Exosomal Gamma-Glutamyltransferase Activity Increased in Patients with Renal Cell Carcinoma with Advanced Clinicopathological Features. Oncology 2020; 98:734-742. [PMID: 32726790 DOI: 10.1159/000508688] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/15/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND There has been no clinically useful diagnostic or prognostic biomarker for renal cell carcinoma (RCC). Serum γ-glutamyltransferase (GGT) activity has been reported to be a prognostic marker for several types of cancer including RCC. Exosomes or small extracellular vesicles present in body fluids have potential as a biomarker. We have recently demonstrated that GGT activity on exosomes isolated from serum is useful for the differential diagnosis of prostate cancer and benign prostate hyperplasia. In this study, we aimed to examine if serum exosomal GGT activity could be a marker for RCC. METHODS We examined GGT1 expression and GGT activity in cell lysates and exosomes from culture medium of HK-2 proximal tubule epithelial and RCC cell lines. GGT activity was measured using a fluorescent probe for GGT, γ-glutamyl hydroxymethyl rhodamine green. Serum and serum exosomal GGT activities were measured in patients with RCC. GGT1 expression in RCC tissues was evaluated by immunohistochemical staining. RESULTS GGT1 levels in exosomes from KMRC-1, OS-RC-2 and 786-O cells were elevated compared with those from HK-2 cells. In exosomes, GGT1 expression correlated with GGT activity determined using a fluorescent probe for GGT. In RCC patients, serum exosomal GGT activity was elevated in those with advanced stages (III/IV vs. I/II, p = 0.037) and those with microvascular invasion (with vs. without, p = 0.034). Immunohistochemical analysis showed that membranous GGT1 expression was increased in RCC with microvascular invasion. Notably, preoperative serum exosomal GGT activity could predict the likelihood of having microvascular invasion diagnosed by pathological examination of surgically resected specimens. CONCLUSIONS Our results suggest that serum exosomal GGT activity could be a clinically useful marker for advanced clinicopathological features of RCC patients, and its combined use with conventional diagnostic modalities may improve the diagnosis and treatment of patients.
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Affiliation(s)
- Kengo Horie
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kyojiro Kawakami
- Research Team for Mechanism of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yasunori Fujita
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoko Matsuda
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Tomio Arai
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Natsuko Suzui
- Department of Pathology, Gifu University Hospital, Gifu, Japan
| | | | - Takuya Koie
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kosuke Mizutani
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masafumi Ito
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
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Yang S, He X, Liu Y, Ding X, Jiang H, Tan Y, Lu H. Prognostic Significance of Serum Uric Acid and Gamma-Glutamyltransferase in Patients with Advanced Gastric Cancer. DISEASE MARKERS 2019; 2019:1415421. [PMID: 31885729 PMCID: PMC6918938 DOI: 10.1155/2019/1415421] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/15/2019] [Accepted: 10/03/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE In this study, we aim to evaluate the prognostic role of serum uric acid and gamma-glutamyltransferase in advanced gastric cancer patients. METHODS A total of 180 patients pathologically diagnosed with advanced gastric cancer were included in this retrospective study. We used time-dependent receiver operating characteristic (ROC) curves to identify the optimal cut-off value of serum uric acid (UA) and gamma-glutamyltransferase (GGT). Survival analysis was performed using the Kaplan-Meier method and log-rank test, and multivariate Cox regression analyses were applied. A nomogram was formulated, and the calibration and discrimination of the nomogram were determined by calibration curve and concordance index (C-index). We validated the results using bootstrap resampling and a separate study on 60 patients collected from 2015 to 2017 using the same criteria in other medical center. RESULTS Both higher serum uric acid (>228 μmol/L) and higher gamma-glutamyltransferase (>14 U/L) had worse OS and PFS. Univariate analysis indicated that serum uric acid (UA) (p < 0.001 and p < 0.001) and gamma-glutamyltransferase (GGT) (p < 0.001 and p = 0.044) were significantly related to overall survival (OS) and progression-free survival (PFS), respectively. Multivariate analysis revealed serum uric acid (UA) and gamma-glutamyltransferase (GGT) were independent prognostic factors for OS (p = 0.012, p = 0.001). The optimal agreement between actual observation and nomogram prediction was shown by calibration curves. The C-indexes of the nomogram for predicting OS and PFS were 0.748 (95% CI: 0.70-0.79) and 0.728 (95% CI: 0.6741-0.7819), respectively. The results were confirmed in the validation cohort. CONCLUSION We observed that both serum UA and GGT were poor prognostic factors in patients with advanced gastric cancer. And we also formulated and validated a nomogram which can predict individual survival for advanced gastric cancer patients.
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Affiliation(s)
- Shanshan Yang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong, China
| | - Xinjia He
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Ying Liu
- Nursing Department, Jinan Seventh People's Hospital, Jinan, Shandong Province, China
| | - Xiao Ding
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Haiping Jiang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Ye Tan
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Haijun Lu
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
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Xiao Y, Meierhofer D. Glutathione Metabolism in Renal Cell Carcinoma Progression and Implications for Therapies. Int J Mol Sci 2019; 20:E3672. [PMID: 31357507 PMCID: PMC6696504 DOI: 10.3390/ijms20153672] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 12/24/2022] Open
Abstract
A significantly increased level of the reactive oxygen species (ROS) scavenger glutathione (GSH) has been identified as a hallmark of renal cell carcinoma (RCC). The proposed mechanism for increased GSH levels is to counteract damaging ROS to sustain the viability and growth of the malignancy. Here, we review the current knowledge about the three main RCC subtypes, namely clear cell RCC (ccRCC), papillary RCC (pRCC), and chromophobe RCC (chRCC), at the genetic, transcript, protein, and metabolite level and highlight their mutual influence on GSH metabolism. A further discussion addresses the question of how the manipulation of GSH levels can be exploited as a potential treatment strategy for RCC.
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Affiliation(s)
- Yi Xiao
- Max Planck Institute for Molecular Genetics, Ihnestraße 63-73, 14195 Berlin, Germany
- Freie Universität Berlin, Fachbereich Biologie, Chemie, Pharmazie, Takustraße 3, 14195 Berlin, Germany
| | - David Meierhofer
- Max Planck Institute for Molecular Genetics, Ihnestraße 63-73, 14195 Berlin, Germany.
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Kawakami K, Fujita Y, Matsuda Y, Arai T, Horie K, Kameyama K, Kato T, Masunaga K, Kasuya Y, Tanaka M, Mizutani K, Deguchi T, Ito M. Gamma-glutamyltransferase activity in exosomes as a potential marker for prostate cancer. BMC Cancer 2017; 17:316. [PMID: 28476099 PMCID: PMC5420129 DOI: 10.1186/s12885-017-3301-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 04/25/2017] [Indexed: 01/27/2023] Open
Abstract
Background Exosomes or extracellular vesicles have the potential as a diagnostic marker for various diseases including cancer. In order to identify novel exosomal markers for prostate cancer (PC), we performed proteomic analysis of exosomes isolated from PC cell lines and examined the usefulness of the marker in patients. Methods Exosomes isolated by differential centrifugation from the culture medium of androgen-dependent LNCaP prostate cancer cell line and its sublines of partially androgen-independent C4, androgen-independent C4–2 and bone metastatic C4–2B were subjected to iTRAQ-based proteomic analysis. Exosomes were also isolated by immunocapture and separated by size exclusion chromatography and density gradient centrifugation. Protein expression was determined by Western blot analysis. GGT activity was measured using a fluorescent probe, γ-glutamyl hydroxymethyl rhodamine green (gGlu-HMRG). Immunohistochemical analysis of tissues was performed using anti-GGT1 antibody. Results Among proteins upregulated in C4–2 and C4–2B cells than in LNCaP cells, we focused on gamma-glutamyltransferase 1 (GGT1), a cell-surface enzyme that regulates the catabolism of extracellular glutathione. The levels of both GGT1 large and small subunits were elevated in exosomes isolated from C4–2 and C4–2B cells by differential centrifugation and by immunocapture with anti-CD9 or -prostate-specific membrane antigen (PSMA) antibody. In cell lysates and exosomes, GGT1 expression correlated with GGT activity. Size exclusion chromatography of human serum demonstrated the presence of GGT activity and GGT1 subunits in fractions positive for CD9. Density gradient centrifugation revealed the co-presence of GGT1 subunits with CD9 in exosomes isolated by differential centrifugation from human serum. Since GGT activity correlated with GGT1 expression in serum exosomes isolated by differential centrifugation, we measured serum exosomal GGT activity in patients. Unexpectedly, we found that serum exosomal GGT activity was significantly higher in PC patients than in benign prostatic hyperplasia (BPH) patients. In support of this finding, immunohistochemical analysis showed increased GGT1 expression in PC tissues compared with BPH tissues. Conclusions Our results suggest that serum exosomal GGT activity could be a useful biomarker for PC. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3301-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kyojiro Kawakami
- Research Team for Mechanism of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yasunori Fujita
- Research Team for Mechanism of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yoko Matsuda
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Tomio Arai
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Kengo Horie
- Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1193, Japan
| | - Koji Kameyama
- Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1193, Japan
| | - Taku Kato
- Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1193, Japan
| | - Koichi Masunaga
- Department of Urology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yutaka Kasuya
- Department of Urology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Masashi Tanaka
- Department of Clinical Laboratory, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Kosuke Mizutani
- Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1193, Japan.
| | - Takashi Deguchi
- Department of Urology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1193, Japan
| | - Masafumi Ito
- Research Team for Mechanism of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.
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11
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Yang F, Zhang S, Yang H, Luo K, Wen J, Hu Y, Hu R, Huang Q, Chen J, Fu J. Prognostic significance of gamma-glutamyltransferase in patients with resectable esophageal squamous cell carcinoma. Dis Esophagus 2015; 28:496-504. [PMID: 24766310 DOI: 10.1111/dote.12227] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gamma-glutamyltransferase (GGT) is a membrane-bound enzyme involved in the glutathione metabolism. Studies suggested that GGT was a marker of apoptotic balance and modulated tumor progression, invasion and drug resistance. Recently, GGT was shown to be associated with the progression of high-grade esophageal epithelial dysplasia to invasive carcinoma. This study was conducted to investigate the value of pre-therapeutic serum GGT levels as prognostic parameter in esophageal squamous cell carcinoma. Six hundred thirty-nine resectable esophageal squamous cell carcinoma patients were recruited in this study and were stratified into two GGT risk groups. The association of pre-therapeutic serum GGT levels and clinical-pathological parameters was examined. Univariate and multivariate survival analyses were performed. GGT serum levels were associated with gender, smoking status, TNM stage and lymph node involvement. Higher pre-therapeutic serum GGT was found in males, smoker, advanced TNM stage and lymph node positive patients. Patients assigned to the low-risk group had higher 5-year overall survival rate (53.1% vs. 33.0%, P < 0.01) and disease-free survival rate (45.2% vs. 23.4%, P < 0.01) than the high-risk group. Patients with high-risk group of GGT had 1.568 (95% confidence interval [CI], 1.259 ∼ 1.952) times the risk of death and 1.582 (95% CI, 1.286 ∼ 1.946) times the risk of disease recurrence contrast with those with low-risk group of GGT. The pre-therapeutic serum GGT is a novel independent prognostic parameter for disease-free survival and overall survival in resectable esophageal squamous cell carcinoma.
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Affiliation(s)
- F Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - S Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - H Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - K Luo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - J Wen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - Y Hu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - R Hu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - Q Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - J Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
| | - J Fu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.,Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China
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12
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Staudigl C, Concin N, Grimm C, Pfeiler G, Nehoda R, Singer CF, Polterauer S. Prognostic relevance of pretherapeutic gamma-glutamyltransferase in patients with primary metastatic breast cancer. PLoS One 2015; 10:e0125317. [PMID: 25915044 PMCID: PMC4411095 DOI: 10.1371/journal.pone.0125317] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/17/2015] [Indexed: 12/30/2022] Open
Abstract
Background Gamma-glutamyltransferase (GGT) is a known marker for apoptotic balance and cell detoxification. Recently, an association of baseline GGT levels and breast cancer incidence, tumor progression and chemotherapy resistance was shown. The purpose of this study was to evaluate the association of pre-therapeutic GGT levels, clinical-pathological parameters and survival in patients with primary metastatic breast cancer (PMBC). Methods In this multicenter analysis, pre-therapeutic GGT levels and clinical-pathological parameters of 114 patients diagnosed with PMBC between 1996 and 2012 were evaluated. The association between GGT levels and clinical-pathological parameters were analysed. Patients were stratified into four GGT risk-groups (GGT < 18.00 U/L: normal low, 18.00 to 35.99 U/L: normal high, 36.00 to 71.99 U/L: elevated and ≥ 72.00 U/L: highly elevated) and survival analyses were performed. Findings Patients in the high risk GGT group had a poorer overall survival, when compared to the low risk group with five-year overall survival rates of 39.5% and 53.7% (p = 0.04), respectively. Patients with larger breast tumors had a trend towards higher GGT levels (p = 0.053). Pre-therapeutic GGT levels were not associated with indicators of aggressive tumor biology such as HER2-status, triple negative histology, or poorly differentiated cancers. Conclusion Pre-therapeutic GGT serum level might serve as a novel prognostic factor for overall-survival in patients with PMBC.
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Affiliation(s)
- Christine Staudigl
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Nicole Concin
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Grimm
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Georg Pfeiler
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Regina Nehoda
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian F. Singer
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Stephan Polterauer
- Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- * E-mail:
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13
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Dalpiaz O, Pichler M, Mrsic E, Reitz D, Krieger D, Venturino L, Bezan A, Stojakovic T, Pummer K, Zigeuner R, Hutterer GC. Preoperative serum-gamma-glutamyltransferase (GGT) does not represent an independent prognostic factor in a European cohort of patients with non-metastatic renal cell carcinoma. J Clin Pathol 2015; 68:547-51. [PMID: 25862811 DOI: 10.1136/jclinpath-2014-202683] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 03/22/2015] [Indexed: 02/07/2023]
Abstract
AIMS Increasing evidence suggests that the serum-gamma-glutamyltransferase (GGT) might correlate with tumour development and growth rates in various human cancer types. Thus, we decided to investigate the potential prognostic impact of the preoperatively assessed serum-GGT in a European cohort of patients with non-metastatic renal cell carcinoma (RCC). METHODS Clinicopathological data from 700 consecutive patients with non-metastatic RCC, operated between 2000 and 2010 at a single tertiary academic centre, were evaluated retrospectively. Preoperative serum-GGT was assessed 1 day before surgery. Patients were categorised using a serum-GGT cut-off value of 40 U/L according to a calculation by receiver operating curve analysis. Patients' cancer-specific survival (CSS), metastasis-free survival (MFS), as well as overall survival (OS) were assessed using the Kaplan-Meier method and Cox proportional models. RESULTS In univariate analysis, an elevated preoperative serum-GGT level (<40 U/L vs ≥40 U/L) was statistically significantly associated with a shorter MFS (HR=1.517, 95% CI 1.047 to 2.197, p=0.027). In multivariate analyses, pathological T-Stage (pT-1 vs pT-2-4, HR=2.065, 95% CI 1.665 to 2.560), tumour grade (G-1+G-2 vs G-3+G-4, HR=1.671, 95% CI 1.261 to 2.213), as well as the presence of histological tumour necrosis (No vs Yes, HR=2.031, 95% CI 1.355 to 3.046) were independent predictors of MFS in patients with RCC, whereas the preoperative serum-GGT failed to reach independent predictor status (<40 U/L vs ≥40 U/L, HR=1.156, 95% CI 0.791 to 1.690). No prognostic role for GGT in OS or CSS could be identified. CONCLUSIONS In the cohort studied, patients with an elevated (≥40 U/L) preoperative serum-GGT had a subsequently shorter MFS only in univariate analysis. In contrast to previous studies, our data failed to demonstrate preoperatively assessed serum-GGT as an independent prognostic factor in patients with non-metastatic RCC.
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Affiliation(s)
- Orietta Dalpiaz
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Edvin Mrsic
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Daniel Reitz
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Daniel Krieger
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Luca Venturino
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Angelika Bezan
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Karl Pummer
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Richard Zigeuner
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Georg C Hutterer
- Department of Urology, Medical University of Graz, Graz, Austria
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14
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Pretherapeutic gamma-glutamyltransferase is an independent prognostic factor for patients with renal cell carcinoma. Br J Cancer 2014; 111:1526-31. [PMID: 25117808 PMCID: PMC4200090 DOI: 10.1038/bjc.2014.450] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/13/2014] [Accepted: 07/15/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Gamma-glutamyltransferase (GGT) regulates apoptotic balance and promotes cancer progression and invasion. Higher pretherapeutic GGT serum levels have been associated with worse outcomes in various malignancies, but there are no data for renal cell carcinoma (RCC). METHODS Pretherapeutic GGT serum levels and clinicopathological parameters were retrospectively evaluated in 921 consecutive RCC patients treated with nephrectomy at a single institution between 1998 and 2013. Gamma-glutamyltransferase was analysed as continuous and categorical variable. Associations with RCC-specific survival were assessed with Cox proportional hazards models. Discrimination was measured with the C-index. Decision-curve analysis was used to evaluate the clinical net benefit. The median postoperative follow-up was 45 months. RESULTS Median pretherapeutic serum GGT level was 25 U l(-1). Gamma-glutamyltransferase levels increased with advancing T (P<0.001), N (P=0.006) and M stages (P<0.001), higher grades (P<0.001), and presence of tumour necrosis (P<0.001). An increase of GGT by 10 U l(-1) was associated with an increase in the risk of death from RCC by 4% (HR 1.04, P<0.001). Based on recursive partitioning-based survival tree analysis, we defined four prognostic categories of GGT: normal low (<17.5 U l(-1)), normal high (17.5 to <34.5 U l(-1)), elevated (34.5 to <181.5 U l(-1)), and highly elevated (⩾181.5 U l(-1)). In multivariable analyses that adjusted for the effect of standard features, both continuously and categorically coded GGT were independent prognostic factors. Adding GGT to a model that included standard features increased the discrimination by 0.9% to 1.8% and improved the clinical net benefit. CONCLUSIONS Pretherapeutic serum GGT is a novel and independent prognostic factor for patients with RCC. Stratifying patients into prognostic subgroups according to GGT may be used for patient counselling, tailoring surveillance, individualised treatment planning, and clinical trial design.
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15
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Dong H, Tang J, Li LH, Ge J, Chen X, Ding J, Men HT, Luo WX, Du Y, Li C, Zhao F, Chen Y, Cheng K, Liu JY. Serum carbohydrate antigen 19-9 as an indicator of liver metastasis in colorectal carcinoma cases. Asian Pac J Cancer Prev 2014; 14:909-13. [PMID: 23621260 DOI: 10.7314/apjcp.2013.14.2.909] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The liver is the organ to which colorectal carcinomas (CRCs) most commonly metastasize, and surgical resection has been established as the most effective and potentially curative treatment for CRC with liver metastasis (LM). Therefore, surveillance of LM is vital for improvement of prognosis of CRC patients. In this study, we aimed to explore the potential value of carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and marker enzymes in indicating LM with CRC. METHODS Three groups of eligible patients with metastatic cancers were retrospectively included: CRC patients with LM (CRC-LM) or without LM (CRC- NLM), and non-CRC patients with LM (NCRC-LM). All metastatic lesions were identified by CT or MRI. Data on characteristics of the patients, the primary site, the locations of metastasis, CA 19-9, CEA, and biochemical parameters were collected for analysis. RESULTS A total of 493 patients were retrospectively included. More alcohol consumption was found in CRC-LM than CRC-NLM. Some biochemical enzymes were found to be significantly higher in groups with LM than without (CRC-LM or NCRC-LM v.s CRC-NLM). Both CEA and CA 19-9 were much higher in CRC-LM than CRC-NLM or NCRC-LM. For CRC patients, CA 19-9, γ-glutamyl transpeptidase, CEA and alcohol consumption were identified as independent factors associated with LM. CONCLUSION Our analysis suggested the CA 19-9 might be a potential valuable indicator for LM of CRC in the clinic.
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Affiliation(s)
- Hang Dong
- Department of Medical Oncology, Cancer Center, the State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
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Elevation of serum γ-glutamyltransferase as a predictor of aggressive tumor behaviors and unfavorable prognosis in patients with intrahepatic cholangiocarcinoma: analysis of a large monocenter study. Eur J Gastroenterol Hepatol 2013; 25:1408-14. [PMID: 23839159 DOI: 10.1097/meg.0b013e328364130f] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE γ-Glutamyltransferase (GGT) has been used as a diagnostic biomarker for hepatobiliary disease. However, little is known about its role in intrahepatic cholangiocarcinoma (ICC). The aim of the present study was to validate the clinical significance of GGT in predicting the prognosis of ICC patients. MATERIALS AND METHODS A total of 411 patients with pathologically confirmed ICC were retrospectively analyzed. Of them, 307 patients underwent hepatectomy, 64 patients with unresectable tumors were treated with chemotherapy (n=42) or transcatheter arterial chemoembolization (n=22), and 40 patients with end-stage disease received supportive treatment. The association between GGT and the clinicopathological features and prognosis was assessed. RESULTS Serum GGT levels were significantly associated with hepatitis B infection (P=0.02), the Child-Pugh grade (P=0.02), vascular invasion (P<0.001), lymph node involvement (P=0.04), and incomplete tumor encapsulation (P=0.009). Survival analysis showed that GGT was an independent predictor of a poor prognosis (hazard ratio=2.36, 95% confidence interval: 1.67-3.34, P=0.001). This prognostic value of GGT was further validated in the mass-forming, normal bilirubin, and Child-Pugh A subgroups. Subsequent recurrence analysis showed that a recurrence-free survival in patients with high GGT levels was significantly shorter than that in those with low GGT levels (6 vs. 12 months, P<0.001). The serum GGT level was an independent predictor of tumor recurrence in ICC patients (hazard ratio=1.59, 95% confidence interval: 1.07-2.37, P=0.02). CONCLUSION Elevation of serum GGT levels is an indicator of aggressive tumor behaviors and a predictor of poor clinical outcomes. It may prove to be a useful biomarker for identifying ICC patients at high risk of early recurrence and unfavorable prognosis.
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Edlinger M, Concin N, Concin H, Nagel G, Ulmer H, Göbel G. Lifestyle-related biomarkers and endometrial cancer survival: Elevated gamma-glutamyltransferase as an important risk factor. Cancer Epidemiol 2013; 37:156-61. [DOI: 10.1016/j.canep.2012.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 12/03/2012] [Accepted: 12/05/2012] [Indexed: 12/11/2022]
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18
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Castellano I, Merlino A. Gamma-Glutamyl Transpeptidases: Structure and Function. GAMMA-GLUTAMYL TRANSPEPTIDASES 2013. [DOI: 10.1007/978-3-0348-0682-4_1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Whitehead ML, Kettlewell PW, Koterwas BA. Elevated serum γ-glutamyltransferase associated with canine renal adenocarcinoma. Vet Rec 2012; 170:362. [DOI: 10.1136/vr.100337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- M. L. Whitehead
- Chipping Norton Veterinary Hospital; Albion Street Chipping Norton Oxfordshire OX7 5BN UK
| | - P. W. Kettlewell
- Chipping Norton Veterinary Hospital; Albion Street Chipping Norton Oxfordshire OX7 5BN UK
| | - B. A. Koterwas
- Chipping Norton Veterinary Hospital; Albion Street Chipping Norton Oxfordshire OX7 5BN UK
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Ünak P, Biber Müftüler FZ, İçhedef Ç, Medine Eİ, Özmen K, Ünak T, Kilçar AY, Gümüşer FG, Parlak Y, Bilgin ES. Synthesis, radiolabeling and in vivo biodistribution of diethylstilbestrol phosphate derivative (DES-P). J Radioanal Nucl Chem 2012. [DOI: 10.1007/s10967-012-1755-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Polterauer S, Hofstetter G, Grimm C, Rahhal J, Mailath-Pokorny M, Kohl M, Concin N, Tempfer C, Marth C, Reinthaller A. Relevance of gamma-glutamyltransferase--a marker for apoptotic balance--in predicting tumor stage and prognosis in cervical cancer. Gynecol Oncol 2011; 122:590-4. [PMID: 21664662 DOI: 10.1016/j.ygyno.2011.05.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 05/10/2011] [Accepted: 05/20/2011] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Recent large epidemiologic population-based studies identified gamma-glutamyltransferase (GGT) as a marker for increased cervical cancer incidence. Furthermore, high levels of GGT seem to increase the risk of progression of high-grade cervical dysplasia to invasive carcinoma. Therefore, we evaluated the association between pre-therapeutic serum GGT levels, tumor stage and prognosis in patients with cervical cancer. MATERIALS AND METHODS In this multi-center trial, pre-therapeutic GGT levels were examined in 692 patients with cervical cancer. GGT levels were correlated with clinico-pathological parameters. Patients were assigned to previously described GGT risk groups and uni- and multivariable survival analyses were performed. RESULTS GGT serum levels were associated with FIGO stage (p<0.0001) and age (r=0.2, p<0.0001) but not with lymph node involvement (p=0.85), and histological type (p=0.98). High-risk GGT group affiliation (p=0.01 and p<0.0001) was associated with poor disease-free and overall survival in a univariate analysis, but not in a multivariable Cox-regression model (p=0.59 and p=0.171). We further investigated the association between prognosis and GGT and observed a linear correlation between GGT and prognosis. Therefore we were not able to identify a clear prognostic cut-off value for GGT in patients with cervical cancer. CONCLUSIONS High GGT--a marker for apoptosis and cervical cancer risk--is associated with advanced tumor stage in patients with cervical cancer.
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Affiliation(s)
- Stephan Polterauer
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
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