Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Clin Genitourin Cancer. 2017 Oct;15(5):598-604. doi: 10.1016/j.clgc.2017.04.011. Epub 2017 Apr 20.
The usefulness of the aspartate transaminase (AST)/alanine transaminase (ALT) ratio (De Ritis ratio) as a predictive biomarker for patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN) remains unclear.
The data from 118 patients were retrospectively evaluated. The endpoints were cancer-specific survival (CSS) and overall survival (OS) after CN. We compared these according to the AST/ALT ratio before and after 1:1 propensity score matching. The independent predictors for CSS and OS were also analyzed.
The area under the receiver operating characteristic curve was 0.603. The maximum Youden index indicated that the cutoff value for the AST/ALT ratio was 1.24. Before matching, a high AST/ALT ratio was significantly associated with inferior CSS and OS (P < .05 for all). After matching, 34 patients each were allocated to the high and low AST/ALT ratio groups. In the matched cohort, CSS and OS tended to be lower in the high AST/ALT ratio group, although the results were not statistically significant (median CSS, 18.4 months vs. not reached, P = .121; OS, 18.4 months vs. not reached, P = .0957). Furthermore, multivariate analyses revealed that the AST/ALT ratio was an independent predictor for CSS and OS (CSS hazard ratio, 2.17, P = .0472; OS hazard ratio, 2.30, P = .0258).
The preoperative AST/ALT ratio can be an effective predictive biomarker for CSS and OS in patients with mRCC.
天冬氨酸转氨酶（AST）/丙氨酸转氨酶（ALT）比值（De Ritis 比值）作为预测接受细胞减灭性肾切除术（CN）的转移性肾细胞癌（mRCC）患者的生物标志物的有用性尚不清楚。
回顾性评估了 118 名患者的数据。终点是 CN 后癌症特异性生存（CSS）和总生存（OS）。我们根据 1:1 倾向评分匹配前后的 AST/ALT 比值进行了比较。还分析了 CSS 和 OS 的独立预测因素。
ROC 曲线下面积为 0.603。最大 Youden 指数表明 AST/ALT 比值的截断值为 1.24。在匹配之前，高 AST/ALT 比值与 CSS 和 OS 较差显著相关（所有 P<.05）。匹配后，每组 34 名患者分别分配到高和低 AST/ALT 比值组。在匹配队列中，高 AST/ALT 比值组的 CSS 和 OS 倾向于较低，但结果无统计学意义（中位 CSS，18.4 个月 vs. 未达到，P=.121；OS，18.4 个月 vs. 未达到，P=.0957）。此外，多变量分析表明，AST/ALT 比值是 CSS 和 OS 的独立预测因素（CSS 风险比，2.17，P=.0472；OS 风险比，2.30，P=.0258）。
术前 AST/ALT 比值可作为 mRCC 患者 CSS 和 OS 的有效预测生物标志物。
