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Elevation of serum γ-glutamyltransferase as a predictor of aggressive tumor behaviors and unfavorable prognosis in patients with intrahepatic cholangiocarcinoma: analysis of a large monocenter study.
Eur J Gastroenterol Hepatol. 2013 Dec; 25(12):1408-14.EJ

Abstract

OBJECTIVE

γ-Glutamyltransferase (GGT) has been used as a diagnostic biomarker for hepatobiliary disease. However, little is known about its role in intrahepatic cholangiocarcinoma (ICC). The aim of the present study was to validate the clinical significance of GGT in predicting the prognosis of ICC patients.

MATERIALS AND METHODS

A total of 411 patients with pathologically confirmed ICC were retrospectively analyzed. Of them, 307 patients underwent hepatectomy, 64 patients with unresectable tumors were treated with chemotherapy (n=42) or transcatheter arterial chemoembolization (n=22), and 40 patients with end-stage disease received supportive treatment. The association between GGT and the clinicopathological features and prognosis was assessed.

RESULTS

Serum GGT levels were significantly associated with hepatitis B infection (P=0.02), the Child-Pugh grade (P=0.02), vascular invasion (P<0.001), lymph node involvement (P=0.04), and incomplete tumor encapsulation (P=0.009). Survival analysis showed that GGT was an independent predictor of a poor prognosis (hazard ratio=2.36, 95% confidence interval: 1.67-3.34, P=0.001). This prognostic value of GGT was further validated in the mass-forming, normal bilirubin, and Child-Pugh A subgroups. Subsequent recurrence analysis showed that a recurrence-free survival in patients with high GGT levels was significantly shorter than that in those with low GGT levels (6 vs. 12 months, P<0.001). The serum GGT level was an independent predictor of tumor recurrence in ICC patients (hazard ratio=1.59, 95% confidence interval: 1.07-2.37, P=0.02).

CONCLUSION

Elevation of serum GGT levels is an indicator of aggressive tumor behaviors and a predictor of poor clinical outcomes. It may prove to be a useful biomarker for identifying ICC patients at high risk of early recurrence and unfavorable prognosis.

Authors+Show Affiliations

Key Laboratory of Carcinogenesis and Cancer Invasion, Liver Cancer Institute & Zhongshan Hospital, Fudan University, Ministry of Education, Shanghai, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23839159

Citation

Yin, Xin, et al. "Elevation of Serum Γ-glutamyltransferase as a Predictor of Aggressive Tumor Behaviors and Unfavorable Prognosis in Patients With Intrahepatic Cholangiocarcinoma: Analysis of a Large Monocenter Study." European Journal of Gastroenterology & Hepatology, vol. 25, no. 12, 2013, pp. 1408-14.
Yin X, Zheng SS, Zhang BH, et al. Elevation of serum γ-glutamyltransferase as a predictor of aggressive tumor behaviors and unfavorable prognosis in patients with intrahepatic cholangiocarcinoma: analysis of a large monocenter study. Eur J Gastroenterol Hepatol. 2013;25(12):1408-14.
Yin, X., Zheng, S. S., Zhang, B. H., Zhou, Y., Chen, X. H., Ren, Z. G., Qiu, S. J., & Fan, J. (2013). Elevation of serum γ-glutamyltransferase as a predictor of aggressive tumor behaviors and unfavorable prognosis in patients with intrahepatic cholangiocarcinoma: analysis of a large monocenter study. European Journal of Gastroenterology & Hepatology, 25(12), 1408-14. https://doi.org/10.1097/MEG.0b013e328364130f
Yin X, et al. Elevation of Serum Γ-glutamyltransferase as a Predictor of Aggressive Tumor Behaviors and Unfavorable Prognosis in Patients With Intrahepatic Cholangiocarcinoma: Analysis of a Large Monocenter Study. Eur J Gastroenterol Hepatol. 2013;25(12):1408-14. PubMed PMID: 23839159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elevation of serum γ-glutamyltransferase as a predictor of aggressive tumor behaviors and unfavorable prognosis in patients with intrahepatic cholangiocarcinoma: analysis of a large monocenter study. AU - Yin,Xin, AU - Zheng,Su-Su, AU - Zhang,Bo-Heng, AU - Zhou,Ying, AU - Chen,Xiao-Hong, AU - Ren,Zheng-Gang, AU - Qiu,Shuang-Jian, AU - Fan,Jia, PY - 2013/7/11/entrez PY - 2013/7/11/pubmed PY - 2014/6/11/medline SP - 1408 EP - 14 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 25 IS - 12 N2 - OBJECTIVE: γ-Glutamyltransferase (GGT) has been used as a diagnostic biomarker for hepatobiliary disease. However, little is known about its role in intrahepatic cholangiocarcinoma (ICC). The aim of the present study was to validate the clinical significance of GGT in predicting the prognosis of ICC patients. MATERIALS AND METHODS: A total of 411 patients with pathologically confirmed ICC were retrospectively analyzed. Of them, 307 patients underwent hepatectomy, 64 patients with unresectable tumors were treated with chemotherapy (n=42) or transcatheter arterial chemoembolization (n=22), and 40 patients with end-stage disease received supportive treatment. The association between GGT and the clinicopathological features and prognosis was assessed. RESULTS: Serum GGT levels were significantly associated with hepatitis B infection (P=0.02), the Child-Pugh grade (P=0.02), vascular invasion (P<0.001), lymph node involvement (P=0.04), and incomplete tumor encapsulation (P=0.009). Survival analysis showed that GGT was an independent predictor of a poor prognosis (hazard ratio=2.36, 95% confidence interval: 1.67-3.34, P=0.001). This prognostic value of GGT was further validated in the mass-forming, normal bilirubin, and Child-Pugh A subgroups. Subsequent recurrence analysis showed that a recurrence-free survival in patients with high GGT levels was significantly shorter than that in those with low GGT levels (6 vs. 12 months, P<0.001). The serum GGT level was an independent predictor of tumor recurrence in ICC patients (hazard ratio=1.59, 95% confidence interval: 1.07-2.37, P=0.02). CONCLUSION: Elevation of serum GGT levels is an indicator of aggressive tumor behaviors and a predictor of poor clinical outcomes. It may prove to be a useful biomarker for identifying ICC patients at high risk of early recurrence and unfavorable prognosis. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/23839159/Elevation_of_serum_γ_glutamyltransferase_as_a_predictor_of_aggressive_tumor_behaviors_and_unfavorable_prognosis_in_patients_with_intrahepatic_cholangiocarcinoma:_analysis_of_a_large_monocenter_study_ L2 - https://doi.org/10.1097/MEG.0b013e328364130f DB - PRIME DP - Unbound Medicine ER -