治疗前天冬氨酸转移酶与丙氨酸转移酶比值在肾细胞癌中预后价值的meta分析

doi:10.19558/j.cnki.10-1020/r.2020.04.011

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摘要 目的: 研究治疗前天冬氨酸转移酶与丙氨酸转移酶比值（AST/ALT）在肾细胞癌中的预后价值。方法: 检索2000年1月1日–2019年4月30日中国生物医学文献数据库（CBMdisc）、中国期刊全文数据库（CNKI）、PubMed、荷兰医学文摘数据库（EMBASE）、考科蓝图书馆（Cochrane Library）、Web of Science数据库,按纳入及排除标准筛选文献、提取资料并评价质量。采用合并的风险比（HR）和相应的95%置信区间（CI）来评价AST/ALT在肾细胞癌中的预后意义。结果: 最终纳入8篇文献提取数据,包含5 173例患者,所有文献质量较高。合并后的数据表明,治疗前AST/ALT增高与肾细胞癌患者不良的总体生存（HR 1.60,95%CI 1.41~1.80,P<0.001）、无进展生存（HR 1.36,95%CI 1.19~1.56,P<0.001）、肿瘤特异性生存（HR 1.77,95%CI 1.42~2.22,P<0.001）明显相关。同时纳入的文献间异质性较小,不存在明显的发表偏倚。结论: 对于肾细胞癌患者,治疗前AST/ALT越高,总体生存、无进展生存和肿瘤特异性生存越差。治疗前AST/ALT水平能作为肾细胞癌的独立预后因子,指导临床治疗方案的制定。

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关键词 ：肾细胞癌, 天冬氨酸转移酶, 丙氨酸转移酶, 预后, meta分析

Abstract：Objective: To investigate the possible prognostic role of pretreatment aspartate transaminase/alanine transaminase ratio (AST/ALT) in renal cell carcinoma. Methods: Eligible studies were comprehensively searched from CBMdisc, CNKI, PubMed, EMBASE, Cochrane Library and Web of Science between January 1st, 2000 and April 30th, 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the relationships. Results: A total of 8 studies embracing 5,173 patients were included in the meta-analysis. All studies were of high quality. Our results indicated that a higher pretreatment AST/ALT was associated with poorer overall survival (HR 1.60, 95% CI 1.41-1.80, P < 0.001), progression-free survival (HR 1.36, 95% CI 1.19-1.56, P < 0.001) and cancer-specific survival (HR 1.77, 95% CI 1.42-2.22, P < 0.001). No marked heterogeneity was identified among included studies. There was no publication bias among these included studies. Conclusions: A higher pretreatment AST/ALT was negatively associated with overall survival, progression-free survival and cancer-specific survival, indicating that it could be an independent prognostic factor in renal cell carcinoma during clinical practice.

Key words： renal cell carcinoma aspartate transaminase alanine transaminase prognosis meta-analysis

收稿日期: 2019-07-08

通讯作者: 顾良友,guliangyouyd1@126.com

引用本文:

王居建, 贾莉, 艾青, 顾良友. 治疗前天冬氨酸转移酶与丙氨酸转移酶比值在肾细胞癌中预后价值的meta分析[J]. 微创泌尿外科杂志, 2020, 9(4): 265-270.
WANG Jujian, JIA Li, AI Qing, GU Liangyou. A meta-analysis for prognostic role of pretreatment aspartate transaminase/alanine transaminase ratio in renal cell carcinoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(4): 265-270.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1611.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I4/265

[1] LJUNGBERG B, BENSALAH K, CANFIELD S, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol, 2015,67(5):913-924.
[2] CHEN W, ZHENG R, BAADE PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016,66(2):115-132.
[3] SABINE DB, MATTHIAS M, SHAHROKH FS, et al. Time to recurrence is a significant predictor of cancer-specific survival after recurrence in patients with recurrent renal cell carcinoma--results from a comprehensive multi-centre database (CORONA/SATURN-Project). BJU Int, 2013,112(7): 909-916.
[4] CARSON KL, DOMINIK M, MARK L, et al. Newcastle-Ottawa Scale: comparing reviewers' to authors' assessments. BMC Med Res Methodol, 2014,14:45.
[5] SUNG HK, EUN YP, JUNGNAM J, et al. The De Ritis and Neutrophil-to-Lymphocyte Ratios May Aid in the Risk Assessment of Patients with Metastatic Renal Cell Carcinoma. J Oncol, 2018,28:1-8.
[6] KANG M, YU J, SUNG HH, et al. Prognostic impact of the pretreatment aspartate transaminase/alanine transaminase ratio in patients treated with first-line systemic tyrosine kinase inhibitor therapy for metastatic renal cell carcinoma. Int J Urol, 2018,25(6):596-603.
[7] SEKAR RR, PATIL D, BAUM Y, et al. A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma. Asian J Urol, 2017,4(4):230-238.
[8] LEE H, LEE SE, BYUN SS, et al. De ritis ratio (aspartate transaminase/alanine transaminase ratio) as a significant prognostic factor after surgical treatment in patients with clear-cell localized renal cell carcinoma: a propensity score-matched study. BJU Int, 2017,119(2):261-267.
[9] ISHIHARA H, KONDO T, YOSHIDA K, et al. Evaluation of preoperative aspartate transaminase/alanine transaminase ratio as an independent predictive biomarker in patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy: a propensity score matching study. Clin Genitourin Cancer, 2017,15(5):598-604.
[10] GU L, WANG Z, CHEN L, et al. A proposal of post-operative nomogram for overall survival in patients with renal cell carcinoma and venous tumor thrombus. J Surg Oncol, 2017,115(7):905-912.
[11] BEZAN A, MRSIC E, KRIEGER D, et al. The preoperative AST/ALT (De ritis) ratio represents a poor prognostic factor in a cohort of patients with nonmetastatic renal cell carcinoma. J Urol, 2015,194(1):30-35.
[12] CANAT L, ATALY HA, AGALAROV S, et al. The effect of AST/ALT (De Ritis) ratio on survival and its relation to tumor histopathological variables in patients with localized renal cell carcinoma. Int Braz J Urol, 2018,44(2):288-295.
[13] DE RITIS F, COLTORTI M, GIUSTI G. An enzymic test for the diagnosis of viral hepatitis: the transaminase serum activities. Clin Chim Acta, 1957,2(1):148-152.
[14] HA YS, KIM SW, CHUN SY, et al. Association between De Ritis ratio (aspartate aminotransferase/alanine aminotransferase) and oncological outcomes in bladder cancer patients after radical cystectomy. BMC Urol, 2019,19(1):10.
[15] GORGEL SN, AKIN Y, KOC EM, et al. Impact of increased aspartate aminotransferase to alanine aminotransferase (De Ritis) ratio in prognosis of testicular cancer. Investig Clin Urol, 2019,60(3):169-175.
[16] WANG H, FANG K, ZHANG J, et al. The significance of De Ritis (aspartate transaminase/alanine transaminase) ratio in predicting pathological outcomes and prognosis in localized prostate cancer patients. Int Urol Nephrol, 2017,49(8):1391-1398.
[17] REJ R. Aspartate aminotransferase activity and isoenzyme proportions in human liver tissues. Clin Chem, 1978,24(11):1971-1979.
[18] VANDER MG, CANTLEY LC, THOMPSON CB. Understanding the warburg effect: the metabolic requirements of cell proliferation. Science, 2009,324(5930):1029-1033.
[19] HANAHAN D, WEINBERG RA. Hallmarks of cancer: the next Generation. Cell, 2011,144(5):646-674.
[20] WEINHOUSE S. On respiratory impairment in cancer cells. Science, 1956,124(3215):267-269.
[21] HSU PP, SABATINI DM. Cancer cell metabolism: Warburg and beyond. Cell, 2008,134(5):703-707.
[22] CREIGHTON CJ, MORGAN M, GUNARATNE PH, et al. Comprehensive molecular characterization of clear cell renal cell carcinoma. Nature, 2013,499(7456):43-49.
[23] HAKIMI AA, REZNIK E, LEE CH, et al. An integrated metabolic Atlas of clear cell renal cell carcinoma. Cancer Cell, 2016,29(1):104-116.