title: Elevated aspartate aminotransferase and monocyte counts predict unfavorable prognosis in patients with malignant pleural mesothelioma.
abstract: Limited biomarkers predicting prognosis of malignant pleural mesothelioma (MPM) have been identified. The present study aims to assess potential laboratory prognostic factors of MPM. We retrospectively reviewed the clinical data of 105 patients with MPM. The overall survival and prognostic factors were assessed by Kaplan-Meier curves and Cox regression analysis. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values. The mean age of the 105 patients (62 men, 43 women) was 56.0 years. The major clinical presentations were dyspnea, cough and chest pain. The most common laboratory abnormalities were thrombocytosis and elevated monocyte count. Significant prognostic factors on univariate analysis were performance status (PS), serum albumin, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), monocyte, platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and treatment strategy. Multivariate analysis showed PS, AST, monocyte, and treatment strategy were statistically significant (p<0.05). Higher AST level and monocyte count were both related to the presence of anemia (p=0.001 and 0.010, respectively) and higher ALP level (p=0.049 and 0.001, respectively). A higher AST level was also associated with higher alanine aminotransferase (ALT) and LDH level (p<0.05). A higher monocyte count was also correlated with male patients, higher white blood cell (WBC), platelet, neutrophil counts, lower red blood cell (RBC) and LMR counts (p<0.05). In conclusion, our data show that PS<2, normal AST level, lower monocyte count, and multimodality treatment are independent positive prognostic factors of MPM. The elevated AST and monocyte levels represent unfavorable prognostic biomarkers of MPM.
authors.forename: A
authors.initials: A
authors.lastname: Zhang
authors.forename: S
authors.initials: S
authors.lastname: Cao
authors.forename: S
authors.initials: S
authors.lastname: Jin
authors.forename: J
authors.initials: J
authors.lastname: Cao
authors.forename: J
authors.initials: J
authors.lastname: Shen
authors.forename: B
authors.initials: B
authors.lastname: Pan
authors.forename: R
authors.initials: R
authors.lastname: Zhu
authors.forename: Y
authors.initials: Y
authors.lastname: Yu
mesh_terms: D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases / Q000032:analysis*; D001792:Blood Platelets / Q000166:cytology; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase; D007958:Leukocyte Count; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: aspartate aminotransferase monocyte.; inflammation; malignant pleural mesothelioma; prognostic analysis