Prognostic significance of gamma-glutamyltransferase in patients with resectable esophageal squamous cell carcinoma.
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.
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
F
F
Yang
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
S
S
Zhang
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
H
H
Yang
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
K
K
Luo
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
J
J
Wen
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
Y
Y
Hu
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
R
R
Hu
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
Q
Q
Huang
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
J
J
Chen
State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Department of Thoracic Oncology, Sun Yat-Sen University Cancer Centre, Guangzhou, Guangdong, China.|Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, China.
J
J
Fu
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012737:Sex Factors; D012907:Smoking / Q000097:blood; D016019:Survival Analysis; D005723:gamma-Glutamyltransferase / Q000097:blood*
D014408:Biomarkers, Tumor; D005723:gamma-Glutamyltransferase
disease-free survival; esophageal squamous cell carcinoma; gamma-glutamyltransferase; overall survival; prognosis