Xu Xin-Sen, Miao Run-Chen, Zhang Ling-Qiang, Wang Rui-Tao, Qu Kai, Pang Qing, Liu Chang
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China E-mail :
Asian Pac J Cancer Prev. 2015;16(15):6255-9. doi: 10.7314/apjcp.2015.16.15.6255.
To evaluate the prognostic value of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) in gallbladder cancer (GBC).
Serum ALP and GGT levels and clinicopathological parameters were retrospectively evaluated in 199 GBC patients. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of ALP and GGT. Then, associations with overall survival were assessed by multivariate analysis. Based on the significant factors, a prognostic score model was established.
By ROC curve analysis, ALP≥210 U/L and GGT≥43 U/L were considered elevated. Overall survival for patients with elevated ALP and GGT was significantly worse than for patients within the normal range. Multivariate analysis showed that the elevated ALP, GGT and tumor stage were independent prognostic factors. Giving each positive factor a score of 1, we established a preoperative prognostic score model. Varied outcomes would be significantly distinguished by the different score groups. By further ROC curve analysis, the simple score showed great superiority compared with the widely used TNM staging, each of the ALP or GGT alone, or traditional tumor markers such as CEA, AFP, CA125 and CA199.
Elevated ALP and GGT levels were risk predictors in GBC patients. Our prognostic model provides infomration on varied outcomes of patients from different score groups.
评估碱性磷酸酶（ALP）和γ-谷氨酰转移酶（GGT）在胆囊癌（GBC）中的预后价值。
回顾性评估199例GBC患者的血清ALP和GGT水平及临床病理参数。进行受试者操作特征（ROC）曲线分析以确定ALP和GGT的临界值。然后，通过多因素分析评估与总生存期的相关性。基于显著因素，建立预后评分模型。
通过ROC曲线分析，ALP≥210 U/L和GGT≥43 U/L被认为升高。ALP和GGT升高患者的总生存期明显差于正常范围患者。多因素分析显示，ALP、GGT升高和肿瘤分期是独立的预后因素。给每个阳性因素评分为1，我们建立了一个术前预后评分模型。不同评分组可显著区分不同的预后结果。通过进一步的ROC曲线分析，与广泛使用的TNM分期、单独的ALP或GGT、或传统肿瘤标志物如CEA、AFP、CA125和CA199相比，简单评分显示出巨大优势。
ALP和GGT水平升高是GBC患者的风险预测指标。我们的预后模型提供了不同评分组患者不同预后结果的信息。
