Correlation between preoperative serum alanine transaminase and the prognosis of postoperative gastric cancer patients / 中华普通外科杂志

ABSTRACT

Objective To study the relationship between preoperative serum ALT and clinicopathological factors in patients with gastric cancer after radical gastrectomy.Methods At the Department of Gastrointestinal Surgery,Tumor Hospital of Harbin Medical University from Jan 2008 to Dec 2010,491 patients were grouped according to ROC curve cut-off point of serum ALT.The relationship between ALT and clinical factors was analyzed,and single-factor and multi-factor survival analysis was performed.Results There were 201 patients with ALT ≤ 20.05 U/L,and 290 patients with ALT ＞ 20.05 U/L Serum ALT was associated with age (x2 =11.231,P ＜ 0.001),depth of tumor invasion (x2 =23.178,P＜0.001),GGT(x2 =19.190,P＜0.001) and AST(x2 =30.771,P＜0.001).The 1-,3-,and 5-year survival rates of patients with ALT ≤ 20.05U/L and ALT ＞ 20.05U/L were 83.5％,51.4％,42.1％ and 66.2％,27.4％,15.7％.There was significant difference between the two groups (x2 =41.711,P＜0.001).Muhivariate analysis showed that tumor TNM stage(HR =1.882,95％ CI1.468-2.413,P ＜0.001),tumor infiltration depth (HR =1.161,95％ CI1.020-1.322,P =0.024),lymph node metastasis (HR =1.177,95％ CI1.042-1.329,P =0.009),Hb (HR =0.726,95％ CI0.579-0.909,P =0.005),neutrophil to lymphocyte rate(HR =1.275,95％ CI1.002-1.623,P =0.048) and ALT(HR =2.191,95％ CI1.754-2.738,P ＜ 0.001) were independent risk factors for the prognosis.Conclusions Serum ALT is an independent risk factor for the prognosis of gastric cancer patients after radical gastrectomy.