γ-谷氨酰转肽酶水平是人类转移性结直肠癌的一种新的不良预后指标。

Gamma-glutamyl transpeptidase level is a novel adverse prognostic indicator in human metastatic colorectal cancer.

机构信息

Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.

出版信息

Colorectal Dis. 2013 Aug;15(8):e443-52. doi: 10.1111/codi.12258.

DOI:10.1111/codi.12258

PMID:23621885

Abstract

AIM

Biomarkers have been utilized for prognosis in colorectal cancer; however, relatively few have been identified. We compared the prognostic value of serum alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and gamma-glutamyl transpeptidase (GGT) with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in patients with metastatic colorectal cancer (mCRC).

METHOD

Blood samples were collected from 239 patients with mCRC presenting between 2005 and 2010 in the Sun Yat-sen University Cancer Center.

RESULTS

CEA (P < 0.001), CA19-9 (P < 0.001), GGT (P < 0.001), ALP (P < 0.001) and LDH (P = 0.001) were statistically significant prognostic factors of overall survival (OS). CEA (P = 0.002) and GGT (P = 0.021) were validated as independent predictors. On univariate analysis, CEA (P = 0.003), CA19-9 (P = 0.006), GGT (P < 0.001) and ALP (P = 0.001) were statistically significant predictive factors of progression-free survival (PFS) in patients having first-line chemotherapy. CEA (P = 0.011) and GGT (P = 0.027) were independent predictors. GGT (P = 0.001), ALP (P = 0.016) and LDH (P = 0.039) levels were correlated with the tumour response rate assessed by CT, whilst CEA (P = 0.724) and CA19-9 (P = 0.822) were not. There was a statistically significant difference in OS (P < 0.001) and PFS (P < 0.001) among patients who had elevations of both CEA and GGT compared with those in whom only one or neither was elevated.

CONCLUSION

Among GGT, LDH and ALP, only GGT plays an independent role with CEA in predicting OS and PFS in mCRC. When coupled with CEA, GGT may lead to improved prognostic predictors.

摘要

目的

生物标志物已被用于结直肠癌的预后；然而，目前被识别的生物标志物相对较少。我们比较了血清碱性磷酸酶（ALP）、乳酸脱氢酶（LDH）和γ-谷氨酰转肽酶（GGT）与癌胚抗原（CEA）和糖类抗原 19-9（CA19-9）在转移性结直肠癌（mCRC）患者中的预后价值。

方法

收集 2005 年至 2010 年间在中山大学肿瘤防治中心就诊的 239 例 mCRC 患者的血液样本。

结果

CEA（P < 0.001）、CA19-9（P < 0.001）、GGT（P < 0.001）、ALP（P < 0.001）和 LDH（P = 0.001）是总生存（OS）的统计学显著预后因素。CEA（P = 0.002）和 GGT（P = 0.021）被验证为独立预测因子。单因素分析显示，CEA（P = 0.003）、CA19-9（P = 0.006）、GGT（P < 0.001）和 ALP（P = 0.001）是一线化疗患者无进展生存（PFS）的统计学显著预测因素。CEA（P = 0.011）和 GGT（P = 0.027）是独立预测因子。GGT（P = 0.001）、ALP（P = 0.016）和 LDH（P = 0.039）水平与 CT 评估的肿瘤反应率相关，而 CEA（P = 0.724）和 CA19-9（P = 0.822）则不然。CEA 和 GGT 均升高的患者与仅有一种或均未升高的患者的 OS（P < 0.001）和 PFS（P < 0.001）有统计学显著差异。