Gamma-glutamyl transferase to aspartate aminotransferase ratio (GSR) predicts prognoses in patients with colorectal cancer with liver metastasis after microwave ablation

• Published in: BMC gastroenterology 2024-09, Vol.24 (1), p.327-11, Article 327
• Main Authors: Huang, Mingzhe, Chen, Zhiliang, Qin, Si, Zhou, Jiaming, Huang, Yan, Peng, Shaoyong, Huang, Pinzhu, Lin, Yi, Alenzi, Maram, Huang, Jun, Lin, Jing, Chen, Zhiyong, Huang, Meijin, Liu, Guangjian
• Format: Article
• Language: English
• Subjects: Ablation; Ablation (Surgery); Ablation Techniques; Adult; Aged; Aged, 80 and over; Aspartate; Aspartate aminotransferase; Aspartate Aminotransferases - blood; Aspartate transaminase; Biomarkers; Biomarkers, Tumor - blood; Cancer; Cancer patients; Cancer therapies; Care and treatment; Chemotherapy; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - blood; Colorectal Neoplasms - pathology; Complications and side effects; Development and progression; Female; Gallbladder diseases; Gamma-glutamyl transpeptidase; gamma-Glutamyltransferase - blood; Health aspects; Humans; Informed consent; Liver cancer; Liver diseases; Liver metastasis; Liver Neoplasms - blood; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Measurement; Medical prognosis; Metabolism; Metastases; Metastasis; Methods; Microwave ablation; Microwaves - therapeutic use; Middle Aged; Multivariate analysis; Neoplasm Recurrence, Local - blood; Oncology, Experimental; Patient outcomes; Patients; Prognosis; Relapse; Retrospective Studies; Risk Factors; Survival; Tomography; Toxicity; Transaminase; Transferases; Tumors; Ultrasonic imaging; γ-Glutamyltransferase
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-024-03419-0

Microwave ablation (MWA) is widely used to eliminate colorectal liver metastases (CRLM). However, the risk of tumor recurrence is difficult to predict due to lack of reliable clinical and biological markers. Elevation of gamma-glutamyl transferase (GGT) and aspartate transaminase (AST) provides signals for liver inflammation and cancer progression. The present study evaluated the association between pre-ablation GGT to AST ratio index (GSR) and hepatic recurrence in patients with CRLM after MWA. A retrospectively analyzed 192 CRLM patients who underwent MWA from January 2013 to December 2017. Pre-ablation GSR was classified into high (≤ 2.34) or low (> 2.34) using the upper quartile value. The prognostic value of GSR and other risk factors for liver progression-free survival (LPFS) and cancer-specific survival (CSS) were evaluated by univariate and multivariate analyses. High GSR was significantly associated with males (P = 0.041), the presence of cholelithiasis (P = 0.012), but not pre-ablation chemotherapy (P = 0.355), which caused significantly increased levels of GGT (P = 0.015) and AST (P = 0.008). GSR showed a significant association with LPFS and CSS through univariate analysis (P = 0.002 and 0.006) and multivariate analysis (P = 0.043 and 0.037). The subgroup analysis demonstrated no interaction between GSR and all variables except for distribution in the sub-analysis of LPFS. Our findings suggest that the pre-ablation GSR can be considered as a promising prognostic indicator for poor prognosis of patients with CRLM underwent MWA. Not applicable.