Repeatedly elevated γ-glutamyltransferase levels are associated with an increased incidence of digestive cancers: A population-based cohort study

Lee, Chang Hoon; Kim, Da Hye; Kwak, Min Sun

doi:10.3748/wjg.v27.i2.176

Cited by 7 publications

(10 citation statements)

References 27 publications

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“…Similarly, in National Health Insurance Service (NHIS) with Korean Cancer Prevention Study (KCPS), associations between serum GGT and site‐specific cancers were diminished in the high BMI (≥25 kg/m 2 ) and the younger group. 9 In accord with study by Lee et al, 20 the prominent effect of GGT on pancreatic cancer initiation was not seen in people who had never smoked or drunk, but in current drinkers. Nevertheless, Mok et al found that baseline GGT and cancer risk were associated irrespective of drinking and smoking habits.…”

Section: Discussionsupporting

confidence: 72%

“… 10 However, a population‐based study in Korea found that the association between GGT and digestive cancer incidence was dominant in men than that in women. 20 In Swedish population, the HRs of overall cancer risks for highly elevated level of GGT (>72 U/L) versus normal level (<18 U/L) were 1.49 (95%CI: 1.17–1.89) for men and 1.14 (95%CI: 0.87–1.50) for women. 11 However, in the latter study, they did not fully consider the sex disparities in serum GGT level, ignoring that men have higher GGT activity than women.…”

Section: Discussionmentioning

confidence: 96%

“… 9 Whether alcohol intake acts as a mediator in the association between serum GGT level and risk of pancreatic cancer is unknown and ambiguous. 20 …”

Section: Discussionmentioning

confidence: 99%

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Circulating gamma‐glutamyl transpeptidase and risk of pancreatic cancer: A prospective cohort study in the UK Biobank

Liao

Yang

et al. 2022

Cancer Medicine

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Pancreatic cancer has the worst prognosis among the common solid tumors, with the five-year overall survival rate of around 10%. 1 Because of lack of effective early detection strategies, most patients are diagnosed with pancreatic cancer at late stages. 2 Many unknowns in pancreatic cancer etiology exist even regarding several well-known risk factors of this disease including smoking, history of diabetes mellitus, and adiposity. 3,4

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 96%

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Circulating gamma‐glutamyl transpeptidase and risk of pancreatic cancer: A prospective cohort study in the UK Biobank

Liao

Yang

et al. 2022

Cancer Medicine

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“…However, several studies have demonstrated that GGT positively correlated with the development of various cancers including breast, lung, endometrium, gastrointestinal tract, and liver [22][23][24][25][26] . Similarly, our analyses showed GGT to be positively associated with overall cancer mortality.…”

Section: Discussionmentioning

confidence: 99%

Gamma-glutamyl transferase and risk of all-cause and disease-specific mortality: a nationwide cohort study

Cho

Jeong

Chung

et al. 2022

Preprint

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Background: Population-based data regarding the prognostic implication of gamma-glutamyl transferase (GGT) have been inconsistent. We examined the association of GGT with all-cause and disease-specific mortality. Methods:Using the Korean nationwide database, we included 9,687,066 subjects without viral hepatitis or cirrhosis who underwent a health examination in 2009. Subjects were classified into three groups by sex-specific tertile of serum GGT levels. The underlying causes of death were classified by 10th Revision of the International Classification of Diseases codes. Results: During the median follow-up period of 8.3 years, 460,699 deaths were identified. All-cause mortality increased as serum GGT levels became higher (hazard ratio [HR], 95% confidence interval [CI]: 1.05, 1.04–1.05 in the middle tertile, and 1.33, 1.32 – 1.34 in the high tertile) compared to the low tertile of serum GGT levels. Similar trends were observed for cardiovascular disease (CVD) (HR, 95% CI: 1.07, 1.05–1.09 in the middle tertile, 1.29, 1.26–1.31 in the high tertile), cancer (HR, 95% CI: 1.08, 1.07–1.10 in the middle tertile, 1.38, 1.36–1.39 in the high tertile), respiratory disease (HR, 95% CI: 1.10, 1.08–1.13 in the middle tertile, 1.39, 1.35–1.43 in the high tertile), and liver disease mortality (HR, 95% CI: 1.74, 1.66–1.83 in the middle tertile, 6.73, 6.46–7.01 in the high tertile). Regardless of smoking, alcohol consumption and history of previous CVD and cancer, a higher serum GGT levels were associated with a higher risk of mortality. Conclusions: Serum GGT levels may be useful for risk assessment of all-cause and disease-specific mortality in general population.

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“…Serum γ-glutamyltransferase (GGT) is a trypsin widely distributed on the surface of glandular and ductal epithelial cells, mainly secreted by the liver, and it is also the most sensitive liver enzyme to re ect biliary obstruction and liver injury (9) . Studies have shown that GGT has a certain correlation with the prognosis and survival of various digestive tract malignancies, but due to a variety of other diseases and conditions (such as renal insu ciency, diabetes, pancreatitis, myocardial infarction, obesity and alcohol intake) Serum GGT levels are elevated and therefore lack speci city (9)(10)(11) .…”

Section: Introductionmentioning

confidence: 99%

Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma

Chen

Zhang

Jia

et al. 2022

Preprint

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BACKGROUND AND AIMS: In recent years, more and more inflammatory indicators have been studied to predict the long-term survival of patients with ampullary carcinoma (AC) after radical resection, but these prognostic indicators are still controversial. Therefore, based on previous inflammation scores, this study established a novel, easily accessible, more feasible and more predictive prognostic marker [Carbohydrate antigen199 to gamma-glutamyltransferase ratio (CA19-9/GGT)] to better assess the prognostic significance in AC patients undergoing radical resection. METHODS: Overall survival (OS) and recurrence-free survival (RFS) were analyzed by Cox regression model. Correlation between CA19-9/GGT and clinicopathological variables were analyzed by Chi-squared test, Fisher ' s exact test, independent sample t test and Mann-Whitney U test. The performance of prognostic indexes is compared by the consistency index (C-index). The prediction accuracy of nomogram is further confirmed by calibration curve and decision curve analysis (DCA). RESULTS: CA19-9/GGT was an independent risk factor affecting OS [P = 0.001, hazard ratio (HR) = 2.459, 95% confidence intervals (CI): 1.450–4.167] and RFS (P = 0.002, HR = 2.333, 95% CI: 1.371–3.971) in multivariate analysis. The optimal cut-off value of CA19-9/GGT was 0.14. In CA19-9/GGT correlation analysis, high risk group (> 0.14) was significantly associated with poor prognosis. The predictive performance of CA19-9/GGT (OS: C-index = 0.753, RFS: C-index = 0.745) was confirmed to be superior to other prognostic indicators according to the C-index. Compared with the simple AJCC staging system, the Nomogram prediction model (OS: C-index = 0.787, RFS: C-index = 0.795) established by the combination of CA19-9/GGT and AJCC 8th TNM staging system has higher prediction accuracy. CONCLUSIONS: CA19-9/GGT was an independent prognostic indicator after radical resection of AC. Incorporating CA19-9/GGT into the AJCC TNM staging system optimized the prediction accuracy of the TNM staging system, and further verified the predictive value of CA19-9/GGT.

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Repeatedly elevated γ-glutamyltransferase levels are associated with an increased incidence of digestive cancers: A population-based cohort study

Cited by 7 publications

References 27 publications

Circulating gamma‐glutamyl transpeptidase and risk of pancreatic cancer: A prospective cohort study in the UK Biobank

Circulating gamma‐glutamyl transpeptidase and risk of pancreatic cancer: A prospective cohort study in the UK Biobank

Gamma-glutamyl transferase and risk of all-cause and disease-specific mortality: a nationwide cohort study

Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma

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