Impact of increased aspartate aminotransferase to alanine aminotransferase (De Ritis) ratio in prognosis of testicular cancer

다국어 초록 (Multilingual Abstract)

Purpose: Imaging studies can show metastasis in testicular cancer (TCa); however, a test for risk of metastasis in TCa has not been described. The ratio of aspartate aminotransferase to alanine aminotransferase, also called the De Ritis ratio (DRR), is used for many other malignancies. We aimed to evaluate the association between preoperatively assessed DRR and prognosis in patients with TCa.
Materials and Methods: One hundred twenty-eight patients with TCa were enrolled in a retrospective study between March 2007 and January 2017. Clinical, biochemical, and pathological data were recorded. Univariate and multivariate logistic regression analyses were used. The prognostic value of DRR and the threshold value were assessed by use of receiver operating characteristic curves. Significance was defined as p<0.05.
Results: Mean follow-up was 37±9.7 months. There were 45 and 73 TCa patients with and without lymph node metastasis, respectively. Lung metastases and other solid organ metastases occurred in 14 and 4 patients, respectively. The optimal DRR threshold was 1.30 for both retroperitoneal lymph node involvement and metastasis. DRR was determined as an independent prognostic factor for retroperitoneal lymph node involvement and organ metastasis in univariate and multivariate analyses (p<0.001, p=0.006 and p=0.002, p=0.047, respectively).
Conclusions: A preoperative DRR greater than 1.30 may be an independent risk factor for retroperitoneal lymph node involvement and organ metastases in patients with TCa.

참고문헌 (Reference)

1 Sobin LH, "UICC International Union Against Cancer" Wiley-Blackwell 249-254, 2009

2 Peyret C, "Tumeurs du testicule. Synthèse et recommandations en onco-urologie" 2 : 60-64, 1993

3 Wanderås EH, "Trends in incidence of testicular cancer in Norway 1955-1992" 31A : 2044-2048, 1995

4 Wang H, "The significance of De Ritis(aspartate transaminase/alanine transaminase)ratio in predicting pathological outcomes and prognosis in localized prostate cancer patients" 49 : 1391-1398, 2017

5 Gorgel SN, "The prognostic significance of preoperatively assessed AST/ALT(De Ritis)ratio on survival in patients underwent radical cystectomy" 49 : 1577-1583, 2017

6 Bezan A, "The preoperative AST/ALT(De Ritis)ratio represents a poor prognostic factor in a cohort of patients with nonmetastatic renal cell carcinoma" 194 : 30-35, 2015

7 Botros M, "The de ritis ratio : the test of time" 34 : 117-130, 2013

8 Ozer J, "The current state of serum biomarkers of hepatotoxicity" 245 : 194-205, 2008

9 Mottet N, "Systematic review 2007: primary treatments of testicular germ cell tumors after radical orchydectomy" 95 : 205-234, 2008

10 Secil M, "State of the art in germ cell tumor imaging" 34 : 156-164, 2016

11 Koshida K, "Significance of placental alkaline phosphatase(PLAP)in the monitoring of patients with seminoma" 77 : 138-142, 1996

12 Tan X, "Prognostic factors of distal cholangiocarcinoma after curative surgery : a series of 84 cases" 60 : 1892-1895, 2013

13 Warburg O, "On respiratory impairment in cancer cells" 124 : 269-270, 1956

14 Stocken DD, "Modelling prognostic factors in advanced pancreatic cancer" 99 : 883-893, 2008

15 Dorward A, "Mitochondrial contributions to cancer cell physiology : redox balance, cell cycle, and drug resistance" 29 : 385-392, 1997

16 Nigam M, "Increasing incidence of testicular cancer in the United States and Europe between 1992 and 2009" 33 : 623-631, 2015

17 Walker-Samuel S, "In vivo imaging of glucose uptake and metabolism in tumors" 19 : 1067-1072, 2013

18 Haugnes HS, "High-dose chemotherapy with autologous stem cell support in patients with metastatic nonseminomatous testicular cancer-a report from the Swedish Norwegian Testicular Cancer Group(SWENOTECA)" 51 : 168-176, 2012

19 Fizazi K, "Early predicted time to normalization of tumor markers predicts outcome in poor-prognosis nonseminomatous germ cell tumors" 22 : 3868-3876, 2004

20 Nishikawa M, "De Ritis(aspartate transaminase/ alanine transaminase)ratio as a significant predictor of recurrence-free survival in patients with upper urinary tract urothelial carcinoma following nephroureterectomy" 34 : 417.e9-417.e15, 2016

21 Germà-Lluch JR, "Clinical pattern and therapeutic results achieved in 1490 patients with germ-cell tumours of the testis: the experience of the Spanish Germ-Cell Cancer Group (GG)" 42 : 553-562, 2002

22 Masterson TA, "Clinical impact of residual extraretroperitoneal masses in patients with advanced nonseminomatous germ cell testicular cancer" 79 : 156-159, 2012

23 Osbun N, "Characteristics of patients with sertoli and leydig cell testis neoplasms from a national population-based registry" 15 : e263-e266, 2017

24 Jemal A, "Cancer statistics, 2009" 59 : 225-249, 2009

25 La Vecchia C, "Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975" 21 : 1323-1360, 2010

26 Fantin VR, "Attenuation of LDH-A expression uncovers a link between glycolysis, mitochondrial physiology, and tumor maintenance" 9 : 425-434, 2006

27 Ha YS, "Association between De Ritis ratio(aspartate aminotransferase/ alanine aminotransferase)and oncological outcomes in bladder cancer patients after radical cystectomy" 19 : 10-, 2019

28 Panchuk RR, "Antioxidants selenomethionine and D-pantethine decrease the negative side effects of doxorubicin in NL/Ly lymphoma-bearing mice" 57 : 180-192, 2016

29 Rawson NS, "An overview of prognostic factors in small cell lung cancer. A report from the Subcommittee for the Management of Lung Cancer of the United Kingdom Coordinating Committee on Cancer Research" 61 : 597-604, 1990

30 De Ritis F, "An enzymic test for the diagnosis of viral hepatitis; the transaminase serum activities" 2 : 70-74, 1957