Department for Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Centre, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Department for Radiotherapy, Gynecologic Cancer Unit, Comprehensive Cancer Centre, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Strahlenther Onkol. 2019 May;195(5):430-440. doi: 10.1007/s00066-019-01430-z. Epub 2019 Feb 8.
Deficiency in butyrylcholinesterase (BChE), a condition commonly noticed in liver damage, inflammation, and malnutrition, has previously been associated with impaired prognosis in different malignancies. The aim of the present study was to investigate the value of pretreatment serum BChE levels as a prognostic biomarker in patients with cervical cancer treated with primary (chemotherapy-[chemo-])radiation therapy.
We retrospectively evaluated data of a consecutive series of patients with cervical cancer treated with primary (chemo-)radiation therapy between 1998 and 2015. Pretreatment serum BChE levels were correlated with clinico-pathological parameters and response to treatment. Uni- and multivariate survival analyses were performed to assess the association between decreased serum BChE levels and progression-free (PFS), cancer-specific (CSS), and overall survival (OS).
A total of 356 patients were eligible for inclusion into the present study. The median (IQR) pretreatment serum BChE level was 6180 (4990-7710) IU/l. Lower serum BChE levels were associated with lower BMI (p < 0.001), advanced tumor stage (p = 0.04), poor treatment response (p = 0.002), the occurrence of disease recurrence (p = 0.003), and the risk of death (p < 0.001). In uni- and multivariate analyses, low pretreatment serum BChE levels were independently associated with shorter PFS (HR 1.8 [1.2-2.6]; p = 0.002), CSS (HR 2.2 [1.4-3.5], p < 0.001), and OS (HR 2.0 [1.4-2.9]; p < 0.001).
Low pretreatment serum BChE levels are associated with advanced tumor stage and poor response to treatment, and serve as an independent prognostic biomarker for shorter PFS, CSS, and OS in patients with cervical cancer treated with primary (chemo-)radiation therapy.
丁酰胆碱酯酶（BChE）缺乏，这在肝损伤、炎症和营养不良中较为常见，先前与不同恶性肿瘤的预后不良有关。本研究的目的是探讨治疗前血清 BChE 水平作为接受原发（化疗-放疗）治疗的宫颈癌患者的预后生物标志物的价值。
我们回顾性评估了 1998 年至 2015 年间接受原发（化疗-放疗）治疗的连续系列宫颈癌患者的数据。治疗前血清 BChE 水平与临床病理参数和治疗反应相关。进行单因素和多因素生存分析，以评估血清 BChE 水平降低与无进展生存期（PFS）、癌症特异性生存期（CSS）和总生存期（OS）之间的关系。
共有 356 例患者符合纳入本研究的条件。中位（IQR）治疗前血清 BChE 水平为 6180（4990-7710）IU/L。较低的血清 BChE 水平与较低的 BMI（p<0.001）、较晚期肿瘤分期（p=0.04）、较差的治疗反应（p=0.002）、疾病复发的发生（p=0.003）和死亡风险（p<0.001）相关。在单因素和多因素分析中，治疗前低血清 BChE 水平与较短的 PFS（HR 1.8[1.2-2.6]；p=0.002）、CSS（HR 2.2[1.4-3.5]，p<0.001）和 OS（HR 2.0[1.4-2.9]；p<0.001）独立相关。
低治疗前血清 BChE 水平与肿瘤晚期和治疗反应差相关，是接受原发（化疗-放疗）治疗的宫颈癌患者较短 PFS、CSS 和 OS 的独立预后生物标志物。
