title: Relevance of gamma-glutamyltransferase--a marker for apoptotic balance--in predicting tumor stage and prognosis in cervical cancer.
abstract: BACKGROUND
  Recent large epidemiologic population-based studies identified gamma-glutamyltransferase (GGT) as a marker for increased cervical cancer incidence. Furthermore, high levels of GGT seem to increase the risk of progression of high-grade cervical dysplasia to invasive carcinoma. Therefore, we evaluated the association between pre-therapeutic serum GGT levels, tumor stage and prognosis in patients with cervical cancer.
  
  
  METHODS
  In this multi-center trial, pre-therapeutic GGT levels were examined in 692 patients with cervical cancer. GGT levels were correlated with clinico-pathological parameters. Patients were assigned to previously described GGT risk groups and uni- and multivariable survival analyses were performed.
  
  
  RESULTS
  GGT serum levels were associated with FIGO stage (p<0.0001) and age (r=0.2, p<0.0001) but not with lymph node involvement (p=0.85), and histological type (p=0.98). High-risk GGT group affiliation (p=0.01 and p<0.0001) was associated with poor disease-free and overall survival in a univariate analysis, but not in a multivariable Cox-regression model (p=0.59 and p=0.171). We further investigated the association between prognosis and GGT and observed a linear correlation between GGT and prognosis. Therefore we were not able to identify a clear prognostic cut-off value for GGT in patients with cervical cancer.
  
  
  CONCLUSIONS
  High GGT--a marker for apoptosis and cervical cancer risk--is associated with advanced tumor stage in patients with cervical cancer.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. polteras@mskcc.org
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
authors.forename: Gerda
authors.initials: G
authors.lastname: Hofstetter
authors.forename: Christoph
authors.initials: C
authors.lastname: Grimm
authors.forename: Jasmin
authors.initials: J
authors.lastname: Rahhal
authors.forename: Mariella
authors.initials: M
authors.lastname: Mailath-Pokorny
authors.forename: Maria
authors.initials: M
authors.lastname: Kohl
authors.forename: Nicole
authors.initials: N
authors.lastname: Concin
authors.forename: Clemens
authors.initials: C
authors.lastname: Tempfer
authors.forename: Christian
authors.initials: C
authors.lastname: Marth
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
mesh_terms: D017209:Apoptosis / Q000502:physiology*; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000201:enzymology* / Q000473:pathology; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D005723:gamma-Glutamyltransferase