Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Road, Guangzhou, Guangdong Province, 510655, China.
Guangdong Institute of Gastroenterology, Guangzhou, Guangdong, China.
BMC Gastroenterol. 2024 Sep 30;24(1):327. doi: 10.1186/s12876-024-03419-0.
Microwave ablation (MWA) is widely used to eliminate colorectal liver metastases (CRLM). However, the risk of tumor recurrence is difficult to predict due to lack of reliable clinical and biological markers. Elevation of gamma-glutamyl transferase (GGT) and aspartate transaminase (AST) provides signals for liver inflammation and cancer progression. The present study evaluated the association between pre-ablation GGT to AST ratio index (GSR) and hepatic recurrence in patients with CRLM after MWA.
A retrospectively analyzed 192 CRLM patients who underwent MWA from January 2013 to December 2017. Pre-ablation GSR was classified into high (≤ 2.34) or low (> 2.34) using the upper quartile value. The prognostic value of GSR and other risk factors for liver progression-free survival (LPFS) and cancer-specific survival (CSS) were evaluated by univariate and multivariate analyses.
High GSR was significantly associated with males (P = 0.041), the presence of cholelithiasis (P = 0.012), but not pre-ablation chemotherapy (P = 0.355), which caused significantly increased levels of GGT (P = 0.015) and AST (P = 0.008). GSR showed a significant association with LPFS and CSS through univariate analysis (P = 0.002 and 0.006) and multivariate analysis (P = 0.043 and 0.037). The subgroup analysis demonstrated no interaction between GSR and all variables except for distribution in the sub-analysis of LPFS.
Our findings suggest that the pre-ablation GSR can be considered as a promising prognostic indicator for poor prognosis of patients with CRLM underwent MWA.
Not applicable.
微波消融（MWA）广泛用于消除结直肠癌肝转移（CRLM）。然而，由于缺乏可靠的临床和生物学标志物，肿瘤复发的风险难以预测。γ-谷氨酰转移酶（GGT）和天冬氨酸转氨酶（AST）的升高为肝炎症和癌症进展提供了信号。本研究评估了 MWA 治疗 CRLM 患者消融前 GGT 与 AST 比值指数（GSR）与肝复发之间的关系。
回顾性分析了 2013 年 1 月至 2017 年 12 月期间接受 MWA 的 192 例 CRLM 患者。使用四分位值将消融前 GSR 分为高（≤2.34）或低（>2.34）。通过单因素和多因素分析评估 GSR 及其他肝无进展生存期（LPFS）和癌症特异性生存期（CSS）危险因素的预后价值。
高 GSR 与男性（P=0.041）、胆囊结石（P=0.012）显著相关，但与消融前化疗无关（P=0.355），而化疗会显著升高 GGT（P=0.015）和 AST（P=0.008）水平。通过单因素分析（P=0.002 和 0.006）和多因素分析（P=0.043 和 0.037），GSR 与 LPFS 和 CSS 显著相关。亚组分析表明，除 LPFS 亚组分析中的分布外，GSR 与所有变量之间无交互作用。
我们的研究结果表明，消融前 GSR 可作为 MWA 治疗 CRLM 患者预后不良的有前途的预测指标。
不适用。
