Cho Yang Hyun, Hwang Jun Eul, Chung Ho Seok, Kim Myung Soo, Hwang Eu Chang, Jung Seung Il, Kang Taek Won, Kwon Dong Deuk, Choi Seock Hwan, Kim Hyun Tae, Kim Tae-Hwan, Kwon Tae Gyun, Noh Joon Hwa, Kim Myung Ki, Kim Chul-Sung, Kang Sung Gu, Kang Seok Ho, Cheon Jun, Lee Chan Ho, Ku Ja Yoon, Ha Hong Koo, Tae Bum Sik, Jeong Chang Wook, Ku Ja Hyeon, Kwak Cheol, Kim Hyeon Hoe
Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757, Korea.
Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea.
Int Urol Nephrol. 2017 Aug;49(8):1383-1390. doi: 10.1007/s11255-017-1613-z. Epub 2017 May 8.
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.
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.
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).
The De Ritis ratio can be a significant predictor of oncological outcomes in patients with upper urinary tract urothelial carcinoma after surgery.
最近，多项研究表明，德瑞蒂斯比值（天冬氨酸转氨酶/丙氨酸转氨酶）可能是某些类型恶性肿瘤有用的预后生物标志物。然而，德瑞蒂斯比值在上尿路尿路上皮癌患者中的预后价值仍 largely 未知。本研究的目的是评估德瑞蒂斯比值在接受根治性肾输尿管切除术（RNU）治疗上尿路尿路上皮癌患者中的预后意义。
回顾性分析了 2004 年至 2015 年在 8 家机构接受 RNU 的 1049 例患者。分析了德瑞蒂斯比值和传统临床病理参数。采用 Kaplan-Meier 法和对数秩检验进行生存分析。使用 Cox 比例风险回归模型进行多变量分析。德瑞蒂斯比值临界值由受试者操作特征（ROC）曲线得出。
ROC 分析显示总体死亡的临界德瑞蒂斯比值为 1.6（p = 0.002）。德瑞蒂斯比值高（>1.6）的患者癌症特异性生存（CSS）和总生存（OS）显著缩短。多变量分析显示德瑞蒂斯比值升高（>1.6）与较短的 CSS（风险比，HR 2.49，95%置信区间，CI 1.70 - 3.64；p = 0.001）和 OS（HR 1.84，95%CI 1.34 - 2.52；p = 0.001）之间存在独立关系。
德瑞蒂斯比值可能是上尿路尿路上皮癌患者术后肿瘤学结局的重要预测指标。
