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Gamma‐glutamyl transpeptidase level is a novel adverse prognostic indicator in human metastatic colorectal cancer
Author(s) -
He W.z.,
Guo G.f.,
Yin C.x.,
Jiang C.,
Wang F.,
Qiu H.j.,
Chen X.x.,
Rong R.m.,
Zhang B.,
Xia L.p.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12258
Subject(s) - medicine , carcinoembryonic antigen , colorectal cancer , gastroenterology , alkaline phosphatase , lactate dehydrogenase , univariate analysis , gamma glutamyltransferase , cancer , multivariate analysis , enzyme , biochemistry , chemistry
Aim Biomarkers have been utilized for prognosis in colorectal cancer; however, relatively few have been identified. We compared the prognostic value of serum alkaline phosphatase ( ALP ), lactate dehydrogenase ( LDH ) and gamma‐glutamyl transpeptidase ( GGT ) with carcinoembryonic antigen ( CEA ) and carbohydrate antigen 19‐9 ( CA 19‐9) in patients with metastatic colorectal cancer (m CRC ). Method Blood samples were collected from 239 patients with m CRC presenting between 2005 and 2010 in the S un Y at‐sen U niversity C ancer C enter. Results CEA ( P < 0.001), CA 19‐9 ( P < 0.001), GGT ( P < 0.001), ALP ( P < 0.001) and LDH ( P = 0.001) were statistically significant prognostic factors of overall survival ( OS ). CEA ( P = 0.002) and GGT ( P = 0.021) were validated as independent predictors. On univariate analysis, CEA ( P = 0.003), CA 19‐9 ( P = 0.006), GGT ( P < 0.001) and ALP ( P = 0.001) were statistically significant predictive factors of progression‐free survival ( PFS ) in patients having first‐line chemotherapy. CEA ( P = 0.011) and GGT ( P = 0.027) were independent predictors. GGT ( P = 0.001), ALP ( P = 0.016) and LDH ( P = 0.039) levels were correlated with the tumour response rate assessed by CT , whilst CEA ( P = 0.724) and CA 19‐9 ( P = 0.822) were not. There was a statistically significant difference in OS ( P < 0.001) and PFS ( P < 0.001) among patients who had elevations of both CEA and GGT compared with those in whom only one or neither was elevated. Conclusion Among GGT , LDH and ALP , only GGT plays an independent role with CEA in predicting OS and PFS in m CRC . When coupled with CEA , GGT may lead to improved prognostic predictors.