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Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?

Year 2023, Volume: 7 Issue: 2, 140 - 144, 07.08.2023
https://doi.org/10.46332/aemj.1077653

Abstract

Purpose: The De Ritis ratio (Aspartate transaminase/alanine transaminase) is a critical prognostic factor for some kinds of malignant tumors. Nevertheless, the De Ritis ratio’s prognostic value in preoperative colon cancer staging is unclear. The purpose of this research was to determine the De Ritis ratio and its prognostic significance for colon cancer.

Materials and Methods: The clinicopathological data of 271 individuals with malign colon cancer were analyzed retrospectively at a single center from January 2010 to January 2018. The relationship between the De Ritis coefficient and clinicopathological findings in patients was evaluated before treatment. To compare the groups, the Mann-Whitney U test and the Kruskal Wallis test were performed.

Results: The results indicated that there were no statistically significant differences between the groups in terms of pre-treatment De Ritis ratio assessment as a staging, localization, tumor diameter, lymph node metastasis, age, and overall survival. However, differences in T staging between groups of male participants were shown to be statistically significant.

Conclusions: The De Ritis ratio evaluation before treatment was not found as an independent variable prognostic factor for the diagnosis and staging of colon cancer. However, future studies may demonstrate the significance of the De Ritis ratio with more participants.

References

  • 1. Chen SL, Li JP, Li LF, Zeng T, He X. Elevated Preoperative Serum Alanine Aminotransferase / Aspartate Aminotransferase (ALT/AST) Ratio Is Associated with Better Prognosis in Patients Un-dergoing Curative Treatment for Gastric Adeno-carcinoma. Int J Mol Sci. 2016;17(6):911.
  • 2. Bezan A, Mrsic E, Krieger D, et al. The Pre-operative AST/ALT (De Ritis) Ratio Represents a Poor Prognostic Factor in a Cohort of Patients with Nonmetastatic Renal Cell Carcinoma. J Urol. 2015;194(1):30-35.
  • 3. Varol U, Kaya E, Oflazoglu U, et al. Prognostic role of De Ritis and basal neutrophil to lympho-cyte ratio in patients with advanced stage pancre-atic cancer [IzmirOncologyGroup (IZOG) Study]. J BUON. 2020;25(2):1063-1069.
  • 4. Knittelfelder O, Delago D, Jakse G, et al. The AST/ALT (De Ritis) Ratio Predicts Survival in Patients with Oral and Oropharyngeal Can-cer. Diagnostics (Basel). 2020;10(11):973.
  • 5. Wu J, Chen L, Wang Y, Tan W, Huang Z. Prog-nostic value of aspartate transaminase to alanine transaminase (De Ritis) ratio in solid tumors: a pooled analysis of 9,400 patients. Onco Targets Ther. 2019;12:5201-5213.
  • 6. Liu L, Wang W, Zhang Y, et al. Declined Pre-operative Aspartate Aminotransferase to Neutro-phil Ratio Index Predicts Poor Prognosis in Pa-tients with Intrahepatic Cholangiocarcinoma after Hepatectomy. Cancer Res Treat. 2018;50(2):538-550.
  • 7. Mori K, Janisch F, Mostafaei H, et al. Prognostic role of preoperative De Ritis ratio in upper tract urothelial carcinoma treated with nephroureterec-tomy. Urol Oncol. 2020;38(6):601.e17-601.e24.
  • 8. Ha YS, Kim SW, Chun SY, et al. Association be-tween De Ritis ratio (aspartateaminotransferase / alanineaminotransferase) and oncological out-comes in bladder cancer patients after radical cystectomy. BMC Urol. 2019;19(1):10.
  • 9. Zhang LX, Lv Y, Xu AM, Wang HZ. The prog-nostic significance of serum gamma-glutamyl transferase levels and AST/ALT in primary he-patic carcinoma. BMC Cancer. 2019;19(1):1-9.
  • 10. Thornburg JM, Nelson KK, Clem BF, et al. Tar-geting aspartate aminotransferase in breast can-cer. Breast Cancer Res. 2008;10(5):1-12.
  • 11. Lee H, Lee SE, Byun SS, Kim HH, Kwak C, Hong SK. De Ritis ratio (aspartatetransaminase / alaninetransaminaseratio) as a significant prog-nostic factor after surgical treatment in patients with clear-cell localized renal cell carcinoma: a propensity score-matched study. BJU Int. 2017;119(2):261-267.
  • 12. Li Y, Fang D, Bao Z, et al. High aspartatetrans-aminase / alaninetransaminase ratio predicts poor prognosis in patients with localized upper tract urothelial cancer: a propensity score-matched study in a large Chinese center. Onco Targets Ther. 2019;12:2635-2648.
  • 13. Durhan A, Şenlikci A, Ergüder E. et al. Is Aspar-tate Aminotransferase to Alanine Aminotransfer-ase (De Ritis Ratio) Helpful in Predicting Breast Cancer? Arch Clin Exp Med. 2021;6(1):13-16.
  • 14. Stocken DD, Hassan AB, Altman DG, et al. Modelling prognostic factors in advanced pan-creatic cancer. Br J Cancer. 2008;99(6):883-893.
  • 15. Tan X, Xiao K, Liu W, Chang S, Zhang T, Tang H. Prognostic factors of distal cholangiocarci-noma after curative surgery: a series of 84 cas-es. Hepatogastroenterology. 2013;60(128):1892-1895.
  • 16. Canat L, Ataly HA, Agalarov S, Alkan I, Altun-rende F. The effect of AST/ALT (De Ritis) ratio on survival and its relation to tumor histopatho-logical variables in patients with localized renal cell carcinoma. Int Braz J Urol. 2018;44(2):288-295.
  • 17. Zhou J, He Z, Ma S, Liu R. AST/ALT ratio as a significant predictor of the incidence risk of prostate cancer. Cancer Med. 2020;9(15):5672-5677.
  • 18. Ahn HJ, Oh HS, Ahn Y, et al. Prognostic Impli-cations of Primary Tumor Resection in Stage IV B Colorectal Cancer in Elderly Patients. Ann Coloproctol. 2014;30(4):175-181.
  • 19. 19. Scheipner L, Smolle MA, Barth D, et al. The AST/ALT Ratio Is an Independent Prognostic Marker for Disease-free Survival in Stage II and III Colorectal Carcinoma. Anti cancer Res. 2021;41(1): 429-436.

De Ritis Oranı (AST/ALT) Kolon Kanseri Evrelerini Tahmin Etmek Için Kullanılabilir Mi?

Year 2023, Volume: 7 Issue: 2, 140 - 144, 07.08.2023
https://doi.org/10.46332/aemj.1077653

Abstract

Amaç: De Ritis oranı (Aspartat transaminaz/alanin transaminaz), bazı malign tümör türleri için kritik bir prognostik faktördür. Bununla birlikte, ameliyat öncesi kolon kanseri evrelemesinde De Ritis oranının prognostik değeri belirsizdir. Bu araştırmanın amacı kolon kanserinde De Ritis oranını ve kolon kanseri için prognostik önemini belirlemektir.

Araçlar ve Yöntem: Ocak 2010'dan Ocak 2018'e kadar tek merkezde malign kolon kanserli 271 bireyin klinikopatolojik verileri geriye dönük olarak analiz edildi. Ameliyat öncesi dönemde hastaların De Ritis oranı ile klinikopatolojik bulguları arasındaki ilişki değerlendirildi. Grupları karşılaştırmak için Mann-Whitney U testi ve Kruskal Wallis testi yapıldı.

Bulgular: Sonuçlar, tedavi öncesi De Ritis oranı değerlendirmesi açısından evreleme, lokalizasyon, tümör çapı, lenf nodu metastazı, yaş ve genel sağkalım açısından gruplar arasında istatistiksel olarak anlamlı bir fark olmadığını gösterdi. Bununla birlikte erkek hastalar arasındaki T evrelemesindeki farklılıkların istatistiksel olarak anlamlı olduğu gösterildi.

Sonuç: Tedavi öncesi değerlendirilen De Ritis oranı kolon kanseri tanı ve evrelemesinde bağımsız bir değişken prognostik faktör değildi. Bununla birlikte, gelecekteki çalışmalar, daha fazla katılımcıyla De Ritis oranının önemini gösterebilir.

References

  • 1. Chen SL, Li JP, Li LF, Zeng T, He X. Elevated Preoperative Serum Alanine Aminotransferase / Aspartate Aminotransferase (ALT/AST) Ratio Is Associated with Better Prognosis in Patients Un-dergoing Curative Treatment for Gastric Adeno-carcinoma. Int J Mol Sci. 2016;17(6):911.
  • 2. Bezan A, Mrsic E, Krieger D, et al. The Pre-operative AST/ALT (De Ritis) Ratio Represents a Poor Prognostic Factor in a Cohort of Patients with Nonmetastatic Renal Cell Carcinoma. J Urol. 2015;194(1):30-35.
  • 3. Varol U, Kaya E, Oflazoglu U, et al. Prognostic role of De Ritis and basal neutrophil to lympho-cyte ratio in patients with advanced stage pancre-atic cancer [IzmirOncologyGroup (IZOG) Study]. J BUON. 2020;25(2):1063-1069.
  • 4. Knittelfelder O, Delago D, Jakse G, et al. The AST/ALT (De Ritis) Ratio Predicts Survival in Patients with Oral and Oropharyngeal Can-cer. Diagnostics (Basel). 2020;10(11):973.
  • 5. Wu J, Chen L, Wang Y, Tan W, Huang Z. Prog-nostic value of aspartate transaminase to alanine transaminase (De Ritis) ratio in solid tumors: a pooled analysis of 9,400 patients. Onco Targets Ther. 2019;12:5201-5213.
  • 6. Liu L, Wang W, Zhang Y, et al. Declined Pre-operative Aspartate Aminotransferase to Neutro-phil Ratio Index Predicts Poor Prognosis in Pa-tients with Intrahepatic Cholangiocarcinoma after Hepatectomy. Cancer Res Treat. 2018;50(2):538-550.
  • 7. Mori K, Janisch F, Mostafaei H, et al. Prognostic role of preoperative De Ritis ratio in upper tract urothelial carcinoma treated with nephroureterec-tomy. Urol Oncol. 2020;38(6):601.e17-601.e24.
  • 8. Ha YS, Kim SW, Chun SY, et al. Association be-tween De Ritis ratio (aspartateaminotransferase / alanineaminotransferase) and oncological out-comes in bladder cancer patients after radical cystectomy. BMC Urol. 2019;19(1):10.
  • 9. Zhang LX, Lv Y, Xu AM, Wang HZ. The prog-nostic significance of serum gamma-glutamyl transferase levels and AST/ALT in primary he-patic carcinoma. BMC Cancer. 2019;19(1):1-9.
  • 10. Thornburg JM, Nelson KK, Clem BF, et al. Tar-geting aspartate aminotransferase in breast can-cer. Breast Cancer Res. 2008;10(5):1-12.
  • 11. Lee H, Lee SE, Byun SS, Kim HH, Kwak C, Hong SK. De Ritis ratio (aspartatetransaminase / alaninetransaminaseratio) as a significant prog-nostic factor after surgical treatment in patients with clear-cell localized renal cell carcinoma: a propensity score-matched study. BJU Int. 2017;119(2):261-267.
  • 12. Li Y, Fang D, Bao Z, et al. High aspartatetrans-aminase / alaninetransaminase ratio predicts poor prognosis in patients with localized upper tract urothelial cancer: a propensity score-matched study in a large Chinese center. Onco Targets Ther. 2019;12:2635-2648.
  • 13. Durhan A, Şenlikci A, Ergüder E. et al. Is Aspar-tate Aminotransferase to Alanine Aminotransfer-ase (De Ritis Ratio) Helpful in Predicting Breast Cancer? Arch Clin Exp Med. 2021;6(1):13-16.
  • 14. Stocken DD, Hassan AB, Altman DG, et al. Modelling prognostic factors in advanced pan-creatic cancer. Br J Cancer. 2008;99(6):883-893.
  • 15. Tan X, Xiao K, Liu W, Chang S, Zhang T, Tang H. Prognostic factors of distal cholangiocarci-noma after curative surgery: a series of 84 cas-es. Hepatogastroenterology. 2013;60(128):1892-1895.
  • 16. Canat L, Ataly HA, Agalarov S, Alkan I, Altun-rende F. The effect of AST/ALT (De Ritis) ratio on survival and its relation to tumor histopatho-logical variables in patients with localized renal cell carcinoma. Int Braz J Urol. 2018;44(2):288-295.
  • 17. Zhou J, He Z, Ma S, Liu R. AST/ALT ratio as a significant predictor of the incidence risk of prostate cancer. Cancer Med. 2020;9(15):5672-5677.
  • 18. Ahn HJ, Oh HS, Ahn Y, et al. Prognostic Impli-cations of Primary Tumor Resection in Stage IV B Colorectal Cancer in Elderly Patients. Ann Coloproctol. 2014;30(4):175-181.
  • 19. 19. Scheipner L, Smolle MA, Barth D, et al. The AST/ALT Ratio Is an Independent Prognostic Marker for Disease-free Survival in Stage II and III Colorectal Carcinoma. Anti cancer Res. 2021;41(1): 429-436.
There are 19 citations in total.

Details

Primary Language English
Subjects Clinical Sciences, Clinical Sciences (Other)
Journal Section Original Articles
Authors

Saygın Altıner 0000-0001-6118-9984

Enes Cebeci 0000-0002-4026-2385

Bedri Burak Sucu This is me 0000-0002-0401-021X

Mert Çöl This is me 0000-0003-2758-5830

Ender Ergüder 0000-0001-5289-3718

Yılmaz Ünal 0000-0001-9712-5827

Salih Tuncal 0000-0002-6633-6557

Mevlüt Recep Pekcici 0000-0002-5566-8134

Early Pub Date July 5, 2023
Publication Date August 7, 2023
Published in Issue Year 2023 Volume: 7 Issue: 2

Cite

APA Altıner, S., Cebeci, E., Sucu, B. B., Çöl, M., et al. (2023). Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?. Ahi Evran Medical Journal, 7(2), 140-144. https://doi.org/10.46332/aemj.1077653
AMA Altıner S, Cebeci E, Sucu BB, Çöl M, Ergüder E, Ünal Y, Tuncal S, Pekcici MR. Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?. Ahi Evran Med J. August 2023;7(2):140-144. doi:10.46332/aemj.1077653
Chicago Altıner, Saygın, Enes Cebeci, Bedri Burak Sucu, Mert Çöl, Ender Ergüder, Yılmaz Ünal, Salih Tuncal, and Mevlüt Recep Pekcici. “Can the De Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?”. Ahi Evran Medical Journal 7, no. 2 (August 2023): 140-44. https://doi.org/10.46332/aemj.1077653.
EndNote Altıner S, Cebeci E, Sucu BB, Çöl M, Ergüder E, Ünal Y, Tuncal S, Pekcici MR (August 1, 2023) Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?. Ahi Evran Medical Journal 7 2 140–144.
IEEE S. Altıner, E. Cebeci, B. B. Sucu, M. Çöl, E. Ergüder, Y. Ünal, S. Tuncal, and M. R. Pekcici, “Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?”, Ahi Evran Med J, vol. 7, no. 2, pp. 140–144, 2023, doi: 10.46332/aemj.1077653.
ISNAD Altıner, Saygın et al. “Can the De Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?”. Ahi Evran Medical Journal 7/2 (August 2023), 140-144. https://doi.org/10.46332/aemj.1077653.
JAMA Altıner S, Cebeci E, Sucu BB, Çöl M, Ergüder E, Ünal Y, Tuncal S, Pekcici MR. Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?. Ahi Evran Med J. 2023;7:140–144.
MLA Altıner, Saygın et al. “Can the De Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?”. Ahi Evran Medical Journal, vol. 7, no. 2, 2023, pp. 140-4, doi:10.46332/aemj.1077653.
Vancouver Altıner S, Cebeci E, Sucu BB, Çöl M, Ergüder E, Ünal Y, Tuncal S, Pekcici MR. Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?. Ahi Evran Med J. 2023;7(2):140-4.

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