title: Model Based on Alkaline Phosphatase and Gamma-Glutamyltransferase for Gallbladder Cancer Prognosis.
abstract: OBJECTIVE
  To evaluate the prognostic value of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) in gallbladder cancer (GBC).
  
  
  METHODS
  Serum ALP and GGT levels and clinicopathological parameters were retrospectively evaluated in 199 GBC patients. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of ALP and GGT. Then, associations with overall survival were assessed by multivariate analysis. Based on the significant factors, a prognostic score model was established.
  
  
  RESULTS
  By ROC curve analysis, ALP≥210 U/L and GGT≥43 U/L were considered elevated. Overall survival for patients with elevated ALP and GGT was significantly worse than for patients within the normal range. Multivariate analysis showed that the elevated ALP, GGT and tumor stage were independent prognostic factors. Giving each positive factor a score of 1, we established a preoperative prognostic score model. Varied outcomes would be significantly distinguished by the different score groups. By further ROC curve analysis, the simple score showed great superiority compared with the widely used TNM staging, each of the ALP or GGT alone, or traditional tumor markers such as CEA, AFP, CA125 and CA199.
  
  
  CONCLUSIONS
  Elevated ALP and GGT levels were risk predictors in GBC patients. Our prognostic model provides infomration on varied outcomes of patients from different score groups.
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China E-mail : liuchangdoctor@163.com.
authors.forename: Xin-Sen
authors.initials: XS
authors.lastname: Xu
authors.forename: Run-Chen
authors.initials: RC
authors.lastname: Miao
authors.forename: Ling-Qiang
authors.initials: LQ
authors.lastname: Zhang
authors.forename: Rui-Tao
authors.initials: RT
authors.lastname: Wang
authors.forename: Kai
authors.initials: K
authors.lastname: Qu
authors.forename: Qing
authors.initials: Q
authors.lastname: Pang
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D019540:Area Under Curve; D018394:CA-125 Antigen / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood* / Q000201:enzymology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D000509:alpha-Fetoproteins; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase