Lifestyle-related biomarkers and endometrial cancer survival: Elevated gamma-glutamyltransferase as an important risk factor

Edlinger, Michael; Concin, Nicole; Concin, Hans; Nagel, Gabriële; Ulmer, Hanno; Göbel, Georg

doi:10.1016/j.canep.2012.12.003

Cited by 17 publications

(28 citation statements)

References 37 publications

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“…We stratified the patients into two risk groups, according to the best cutoff value determined by ROC curve generated from MedCalc, with the highest combined sensitivity and specificity with respect to distinguishing 5‐year survivors from non‐survivors. Similar to the previous results that high level of GGT associated with poorer outcome in cervical cancer, and endometrial cancer, we found that high‐risk group of GGT was associated with poorer prognosis in patients with ESCC. As previously described, serum level of GGT was elevated in the lymph node metastasis of ESCC patients, and lymph node status was a strong prognostic factor for ESCC.…”

Section: Discussionsupporting

confidence: 91%

Prognostic significance of gamma-glutamyltransferase in patients with resectable esophageal squamous cell carcinoma

Zhang

Yang

et al. 2014

Dis Esophagus

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Gamma-glutamyltransferase (GGT) is a membrane-bound enzyme involved in the glutathione metabolism. Studies suggested that GGT was a marker of apoptotic balance and modulated tumor progression, invasion and drug resistance. Recently, GGT was shown to be associated with the progression of high-grade esophageal epithelial dysplasia to invasive carcinoma. This study was conducted to investigate the value of pre-therapeutic serum GGT levels as prognostic parameter in esophageal squamous cell carcinoma. Six hundred thirty-nine resectable esophageal squamous cell carcinoma patients were recruited in this study and were stratified into two GGT risk groups. The association of pre-therapeutic serum GGT levels and clinical-pathological parameters was examined. Univariate and multivariate survival analyses were performed. GGT serum levels were associated with gender, smoking status, TNM stage and lymph node involvement. Higher pre-therapeutic serum GGT was found in males, smoker, advanced TNM stage and lymph node positive patients. Patients assigned to the low-risk group had higher 5-year overall survival rate (53.1% vs. 33.0%, P < 0.01) and disease-free survival rate (45.2% vs. 23.4%, P < 0.01) than the high-risk group. Patients with high-risk group of GGT had 1.568 (95% confidence interval [CI], 1.259 ∼ 1.952) times the risk of death and 1.582 (95% CI, 1.286 ∼ 1.946) times the risk of disease recurrence contrast with those with low-risk group of GGT. The pre-therapeutic serum GGT is a novel independent prognostic parameter for disease-free survival and overall survival in resectable esophageal squamous cell carcinoma.

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Section: Discussionsupporting

confidence: 91%

Prognostic significance of gamma-glutamyltransferase in patients with resectable esophageal squamous cell carcinoma

Zhang

Yang

et al. 2014

Dis Esophagus

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“…All studies are in agreement with our findings in AMORIS and show that high levels of GGT are an indicator of elevated cancer risk and poor disease prognosis. Three studies showed that high pre-therapeutic levels of GGT are associated with advanced tumour stage and serve as an independent prognostic marker of poor prognosis in gynaecological cancers [ 122 , 125 , 126 ]. A case-cohort study in Taiwanese men showed that high levels of GGT were associated with risk of all-cause death, all cancer, and hepatocellular carcinoma (HCC) mortality [ 124 ].…”

Section: Liver Metabolismmentioning

confidence: 99%

Metabolic serum biomarkers for the prediction of cancer: a follow-up of the studies conducted in the Swedish AMORIS study

et al. 2015

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The Swedish Apolipoprotein MOrtality RISk study (AMORIS) contains information on more than 500 biomarkers collected from 397,443 men and 414,630 women from the greater Stockholm area during the period 1985–1996. Using a ten-digit personal identification code, this database has been linked to Swedish national registries, which provide data on socioeconomic status, vital status, cancer diagnosis, comorbidity, and emigration. Within AMORIS, 18 studies assessing risk of overall and site-specific cancers have been published, utilising a range of serum markers representing glucose and lipid metabolism, immune system, iron metabolism, liver metabolism, and bone metabolism. This review briefly summarises these findings in relation to more recently published studies and provides an overview of where we are today and the challenges of observational studies when studying cancer risk prediction.Overall, more recent observational studies supported previous findings obtained in AMORIS, although no new results have been reported for serum fructosamine and inorganic phosphate with respect to cancer risk. A drawback of using serum markers in predicting cancer risk is the potential fluctuations following other pathological conditions, resulting in non-specificity and imprecision of associations observed. Utilisation of multiple combination markers may provide more specificity, as well as give us repeated instead of single measurements. Associations with other diseases may also necessitate further analytical strategies addressing effects of serum markers on competing events in addition to cancer. Finally, delineating the role of serum metabolic markers may generate valuable information to complement emerging clinical studies on preventive effects of drugs and supplements targeting metabolic disorders against cancer.

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“…Oxidative stress and inflammation are also pathways implicated in cancer development and progression, and positive GGT associations with risks of various cancer types have been demonstrated by several prospective studies [9][10][11][12]. Quite opposite to the abundance of cancer risk studies, relatively few studies have investigated the prognostic role of serum GGT in cancer outcomes: increased serum GGT has been inversely associated with survival in gastric cancer [13], colorectal cancer [14], ovarian cancer [15], breast cancer [16], endometrial cancer [17,18], cervical cancer [19], and renal cell carcinoma [20].…”

Section: Introductionmentioning

confidence: 99%

Serum gamma-glutamyltransferase and the overall survival of metastatic pancreatic cancer

Xiao

Yang

et al. 2019

Preprint

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Background: Accumulating evidence suggests that Gamma-glutamyltransferase (GGT) may be involved in cancer occurrence and progression. However, the prognostic role of serum GGT in pancreatic cancer (PC) survival lacks adequate evaluation. In this study, we aimed to analyze the association between serum GGT measured at diagnosis and overall survival (OS) in patients with metastatic PC. Methods: We identified 320 patients with histopathologically confirmed metastatic pancreatic ductal adenocarcinoma (PDAC) diagnosed during 2015 and 2016 at a specialized cancer hospital in southwestern China. Univariate and multivariate Cox proportional-hazards models were used to determine associations between serum GGT and OS in metastatic PDAC. Results: Controlled for possible confounding factors, serum GGT was significantly associated with OS: serum GGT >48 U/L yielded a hazard ratio of 1.53 (95%CI: 1.19-1.97) for mortality risk. A significant dose-response association between serum GGT and OS was also observed. Subgroup analysis showed a possible interaction between GGT and blood glucose level. Conclusion: Serum GGT could be a potential indicator of survival in metastatic PDAC patients. Underlying mechanisms for this association should be investigated.

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Lifestyle-related biomarkers and endometrial cancer survival: Elevated gamma-glutamyltransferase as an important risk factor

Cited by 17 publications

References 37 publications

Prognostic significance of gamma-glutamyltransferase in patients with resectable esophageal squamous cell carcinoma

Prognostic significance of gamma-glutamyltransferase in patients with resectable esophageal squamous cell carcinoma

Metabolic serum biomarkers for the prediction of cancer: a follow-up of the studies conducted in the Swedish AMORIS study

Serum gamma-glutamyltransferase and the overall survival of metastatic pancreatic cancer

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