The De Ritis (Aspartate Transaminase/Alanine Transaminase) Ratio as a Prognosticator in Patients With End-stage Renal Disease-associated Renal Cell Carcinoma

被引：12

作者：

Ikeda, Takashi ^{[1
]}

Ishihara, Hiroki ^{[1
]}

Takagi, Toshio ^{[1
]}

Fukuda, Hironori ^{[1
]}

Yoshida, Kazuhiko ^{[1
]}

Iizuka, Junpei ^{[1
]}

Kobayashi, Hirohito ^{[1
]}

Okumi, Masayoshi ^{[1
]}

Ishida, Hideki ^{[1
]}

Kondo, Tsunenori ^{[2
]}

Tanabe, Kazunari ^{[1
]}

机构：

[1] Tokyo Womens Med Univ, Dept Urol, Tokyo, Japan

[2] Tokyo Womens Med Univ, Dept Urol, Med Ctr East, Tokyo, Japan

来源：

CLINICAL GENITOURINARY CANCER | 2020年 / 18卷 / 03期

关键词：

ALT; AST; Dialysis; ESRD; Renal cancer; AMINOTRANSFERASE ACTIVITY; HEMODIALYSIS-PATIENTS; 3; CONTINENTS; DIALYSIS; CANCER; PROGNOSIS; SEROCONVERSION; PREVALENCE; PATTERNS; SURVIVAL;

D O I：

10.1016/j.clgc.2019.12.012

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The prognostic association of the aspartate transaminase/alanine transaminase ratio with end-stage renal disease (ESRD) eassociated renal cell carcinoma (RCC) remains unknown. We retrospectively evaluated 243 patients receiving radical nephrectomy for nonmetastatic ESRD-associated RCC. Prognostic factors associated with cancer-specific survival after radical nephrectomy were analyzed. Results revealed that the aspartate transaminase/alanine transaminase ratio was significantly associated with cancer-specific survival after radical nephrectomy for ESRD-associated RCC. Background: The aspartate transaminase (AST)/alanine transaminase (ALT) ratio (ie, the De Ritis ratio) is associated with prognosis in some types of cancers including renal cell carcinoma (RCC). Meanwhile, an effective prognosticator for end-stage renal disease (ESRD)eassociated RCC remains unknown. Thus, we investigated the prognostic impact of the AST/ALT ratio in patients with ESRD-associated RCC. Patients and Methods: We retrospectively evaluated 243 patients receiving radical nephrectomy for nonmetastatic ESRD-associated RCC. The patients were divided according to the cutoff value of preoperative AST/ALT ratio. Prognostic factors associated with cancer-specific survival (CSS) after radical nephrectomy were analyzed. Results: The maximum Youden index showed that the cutoff value of the AST/ALT ratio was 1.42. The high AST/ALT ratio group (>= 1.42; n = 88) had a significantly shorter 10-year CSS than the low AST/ALT ratio group (64.3% vs. 87.2%; P = .0027). Multivariate analysis revealed that the AST/ALT ratio was an independent prognostic factor of CSS (hazard ratio [HR], 3.03; P = .0020), together with serum C-reactive protein level (HR, 4.84; P < .0001), pathologic stage (HR, 2.79; P = .0030), and tumor grade (HR, 7.08; P = .0087). Based on these independent factors, the patients were further classified into 3 groups: low (0-1 factor), intermediate (2 factors), and high risk (3-4 factors). The 10-year CSS in the high-risk group was significantly shorter than that of the other groups (68.9% vs. 70.9% vs. 94.4%; P < .0001). Conclusion: The AST/ALT ratio can aid in the risk classification of patients with ESRD-associated RCC. (C) 2019 Elsevier Inc. All rights reserved.

引用

页码：236 / +

页数：6

共 32 条

[1]

[Anonymous], UROL ONCOL

[2] The Preoperative AST/ALT (De Ritis) Ratio Represents a Poor Prognostic Factor in a Cohort of Patients with Nonmetastatic Renal Cell Carcinoma [J].