CA19-9 Level to Serum γ-Glutamyltransferase as a Potential Prognostic Biomarker in Patients with Pancreatic Head Carcinoma

Abstract

Background The aim of this study was to reduce the influence of biliary obstruction on carbohydrate antigen 19-9 level (CA19-9) by introducing the CA19-9 level to serum γ-glutamyltransferase (GGT) ratio as an indicator, and ultimately to reveal the correlation between CA19-9/GGT and the prognosis of patients with pancreatic head carcinoma (PHC). Methods A total of 339 enrolled patients who underwent pancreatoduodenectomy for PHC in Beijing ChaoYang Hospital from January 2010 to December 2019 were analyzed retrospectively. The optimal cut-off value, according to which patients were divided into a low-ratio group (Group 1, n=179) and a high-ratio group (Group 2, n=160), was determined by the ROC curve obtained from preoperative CA19-9/GGT and 1-year survival. Through univariate and multivariate analyses, risk factors for postoperative tumor recurrence and long-term survival were screened out among PHC patients. Results The best cut-off value of CA19-9/GGT was 2.07 (area under the curve=0.567, 95% CI 0.498–0.636). Compared with Group 2, Group 1 had lower CA19-9, and higher GGT, total bilirubin (TB) and lymph-node metastasis rate ( P <0.05). The 1-, 2- and 3-year disease-free survival rates of patients in Groups 1 and 2 were 68.2%, 42.5% and 28.2%, and 42.2%, 19.3% and 18.3%, respectively ( P =0.000), and the 1-, 2- and 3-year overall survival rates were 79.1%, 50.7% and 29.1%, and 56.7%, 22.2% and 17.2%, respectively ( P =0.000). Multivariate analysis showed that CA19-9/GGT, portal system invasion and lymph-node metastasis were independent risk factors for postoperative tumor recurrence and long-term survival among patients with PHC. Conclusion Compared with CA19-9 level alone, CA19-9/GGT plays a more precise role in the evaluation of postoperative tumor recurrence and the long-term prognosis of PHC patients. The lower the ratio, the better the long-term prognosis. The CA19-9/GGT ratio may prove to be a useful biomarker for identifying PHC patients at high risk of early recurrence and unfavorable prognosis.

Identification of GGT5 as a Novel Prognostic Biomarker for Gastric Cancer and its Correlation With Immune Cell Infiltration

“…Recent studies have found a correlation between elevated serum levels of GGT and various digestive tumors, including pancreatic head carcinoma (Lyu et al, 2021), colorectal carcinoma (Gong et al, 2021), and gallbladder carcinoma (Su et al, 2021). A linear association was also detected between increased levels of GGT and cancer-related deaths (Albhaisi and Qayyum, 2021).…”

Gamma-glutamyltransferase-associated glycoprotein patterns in human seminal plasma of normozoospermic men: a new aspect of biomarker heterogeneity

“…It is suggested that this may play a functional modulatory role, in terms of inhibiting or enhancing the activity of associated enzymes 45 . So far, in an unrelated examination, possible use of the ratio of CA19-9 to total serum GGT is suggested for the prediction of recurrence and long-term prognosis in patients with pancreatic head carcinoma and cholangiocarcinoma 47,48 .…”

Seroprevalence and Biomarkers Detection of Human Herpes Virus (HHV-8) in Patients with Kaposi Sarcoma

“…And the high levels of Ca19.9 is a marker not only for determining the incidence of pancreatic tumors, but perhaps there are neighboring organs that have been invaded by these tumors, such as the liver, so this indicator is of great importance in determining these cancers [30]. Lyu et al, (2021) has been proven a high percentage in levels of CA19.9 for patients with pancreatic tumors and that this indicator is of great importance in determining glandular tumors, especially pancreatic tumors. While in the benign tumors of the pancreas, there were average levels in the proportions of measurements of CA19.9 [31].…”

“…Lyu et al, (2021) has been proven a high percentage in levels of CA19.9 for patients with pancreatic tumors and that this indicator is of great importance in determining glandular tumors, especially pancreatic tumors. While in the benign tumors of the pancreas, there were average levels in the proportions of measurements of CA19.9 [31]. Poruk et al, (2013) explained there is a high accuracy and sensitivity in using the CI 19.9 marker in determining the incidence of pancreatic cancer compared to benign tumors [32].…”