Copyright
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Analysis of alkaline phosphatase and γ-glutamyltransferase after radiofrequency ablation of primary liver cancer: A retrospective study
Wen-Yu Huang, Sheng Zheng, Dan Zhu, Ying-Lang Zeng, Juan Yang, Xue-Li Zeng, Pei Liu, Shun-Ling Zhang, Ming Yuan, Zhi-Xia Wang
Wen-Yu Huang, Ying-Lang Zeng, Department of Tumor and Vascular Interventional Therapy, Xiamen Humanity Hospital, Xiamen 361000, Fujian Province, China
Sheng Zheng, Department of Gastroenterology, The Third People's Hospital of Yunnan Province, Kunming 650011, Yunnan Province, China
Dan Zhu, Medical Imaging Center, Qian Wei Hospital of Jilin Province, Changchun 130000, Jilin Province, China
Juan Yang, Department of Science and Education, The Third People's Hospital of Yunnan Province, Kunming 650011, Yunnan Province, China
Xue-Li Zeng, Pei Liu, Shun-Ling Zhang, Graduate School of Clinical Medicine, Dali University, Dali 671000, Yunnan Province, China
Ming Yuan, Department of Hepatobiliary Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Zhi-Xia Wang, Department of Oncology, The Affiliated Shuyang Hospital of Xuzhou Medical University, Suqian 223600, Jiangsu Province, China
Co-first authors: Wen-Yu Huang and Sheng Zheng.
Author contributions: Huang WY and Zheng S contribute equally to this study as co-first authors. Huang WY wrote the manuscript; Zheng S, Zhu D, Zeng YL, Yang J, Zeng X L, Liu P, Zhang SL and Yuan M collected the data; Wang ZX guided the study; all authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Supported by Yunnan Province High-level Scientific and Technological Talents and Innovation Team Selection Special, No. 202405AC350067; Basic Research Joint Special General Project of Yunnan Provincial Local Universities (Part), No. 202301BA070001-029 and No. 202301BA070001-044; Scientific Research Fund Project of Education Department of Yunnan Province, No. 2023J0926; and The 8th Research Project of Education and Teaching Reform of Dali University (Special Medical Education Reform Project), No. 2022JGYX08-01 and No. 2022JGYX08-02.
Institutional review board statement: This study was approved by the Medical Research Ethics Committee.
Informed consent statement: This study has obtained informed consent and signed treatment consent from patients and their families.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Statistical analysis plan, informed consent form, and clinical study report will also be shared if requested. Emails could be sent to the address below to obtain the shared data:
wzx1230727@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Zhi-Xia Wang, MM, Doctor, Department of Oncology, The Affiliated Shuyang Hospital of Xuzhou Medical University, No. 9 Yingbin Avenue, Shucheng Town, Shuyang County, Suqian 223600, Jiangsu Province, China.
wzx1230727@163.com
Received: May 10, 2024
Revised: July 29, 2024
Accepted: August 2, 2024
Published online: September 27, 2024
Processing time: 131 Days and 6.9 Hours
BACKGROUND
Changes in alkaline phosphatase (ALP) and γ-glutamyltransferase (GGT) levels in patients with primary liver cancer (PLC) after radiofrequency ablation (RFA). Hepatocellular carcinoma is a malignant tumor with high incidence worldwide. As a common local treatment, RFA has attracted much attention for its efficacy and influence on liver function.
AIM
To investigate the effect of serum ALP and GGT levels on the prognosis of patients with PLC treated by RFA.
METHODS
The preoperative clinical data of 165 patients who were pathologically or clinically diagnosed with PLC and who received RFA in our hospital between October 2018 and June 2023 were collected. The chi-square test was used to compare the data between groups. The Kaplan-Meier method and Cox regression were used to analyze the associations between serum ALP and GGT levels and overall survival, progression-free survival (PFS) and clinical characteristics of patients before treatment.
RESULTS
The 1-year survival rates of patients with normal (≤ 135 U/L) and abnormal (> 135 U/L) serum ALP before treatment were 91% and 79%, respectively; the 2-year survival rates were 90% and 68%, respectively; and the 5-year survival rates were 35% and 18%, respectively. The difference between the two groups was statistically significant (P = 0.01). Before treatment, the 1-year survival rates of patients with normal serum GGT levels (≤ 45 U/L) and abnormal serum GGT levels (> 45 U/L) were 95% and 87%, the 2-year survival rates were 85% and 71%, and the 5-year survival rates were 37% and 21%, respectively. The difference between the two groups was statistically significant (P < 0.001). Serum ALP [hazard ratio (HR) = 1.766, 95% confidence interval (95%CI): 1.068-2.921, P = 0.027] and GGT (HR = 2. 312, 95%CI: 1.367-3.912, P = 0.002) is closely related to the overall survival of PLC patients after RF ablation and is an independent prognostic factor. The 1-year PFS rates were 72% and 50%, the 2-year PFS rates were 52% and 21%, and the 5-year PFS rates were 14% and 3%, respectively. The difference between the two groups was statistically significant (P < 0001). The 1-year PFS rates were 81% and 56% in patients with normal and abnormal serum GGT levels before treatment, respectively; the 2-year PFS rates were 62% and 35%, respectively; and the 5-year PFS rates were 18% and 7%, respectively, with statistical significance between the two groups (P < 0.001). The serum ALP concentration (HR = 1. 653, 95%CI: 1.001-2.729, P = 0.049) and GGT (HR = 1.949, 95%CI: 1.296-2.930, P = 0.001) was closely associated with PFS after RFA in patients with PLC. The proportion of male patients with abnormal ALP levels is high, the Child-Pugh grade of liver function is poor, and the incidence of ascites is high. Among GGT-abnormal patients, the Child-Pugh grade of liver function was poor, the tumor stage was late, the proportion of patients with tumors ≥ 5 cm was high, and the incidence of hepatic encephalopathy was high.
CONCLUSION
Serum ALP and GGT levels before treatment can be used to predict the prognosis of patients with PLC after RFA, and they have certain guiding significance for the long-term survival of patients with PLC after radiofrequency therapy.
Core Tip: Clinical data of patients with primary liver cancer (PLC) treated with radiofrequency ablation (RFA) were retrospectively analyzed to evaluate the changes in alkaline phosphatase (ALP) and γ-glutamyltransferase (GGT) levels before and after treatment. The subjects of this study were PLC patients undergoing RFA. By collecting ALP and GGT detection results at different time points before and after treatment, the dynamic trend and clinical significance of these indicators were analyzed.
