Abstract 468P
Background
The state of liver function affects the treatment of tumors. However, the relationship between transaminase and prognosis is not clear. Lactate dehydrogenase (LDH) is one of the common biomarkers affecting the prognosis of tumor, however, its specificity is not high. The aim of our study was to combine the two to find a highly specific prognostic factor for colorectal cancer (CRC).
Methods
Our study included 751 patients histopathologically confirmed CRC. Preoperative serum examinations were performed within one week before surgery. The SLR was defined as the level of aspartate aminotransferase divided by alanine aminotransferase. Patients were divided into a high-level group or a low-level group. Patients with a low SLR and low LDH level were scored as 0, those with a high SLR or a high LDH level were scored as 1, and those with a high SLR and high LDH level were scored as 2. The entire population was randomly assigned to a training (526) or testing (225) group. Chi-square tests, Kaplan-Meier survival analyses, and Cox regression analyses were used to evaluate prognosis.
Results
The median follow-up time was 35.4 months. Besides, the combination of SLR and LDH (SLR-LDH) was an independent prognostic factor in patients with resectable CRC (HR: 1.316; 95% CI, 1.041-1.664). More interestingly, the prognostic model based on age, sex, TNM stage, differenation, location, lymph node ratio, circumferential margin, vascular cancer embolus status, nerve infiltration status, SLR-LDH, CEA and CA199 was found to present exceptional performance in overall survival (OS) prediction [C-index: 0.823 (95% CI, 0.78-0.87) and Brier score: 0.031 for 1-year OS and 0.063 for 3-year OS]. The area under the curve (AUC) values were illustrated the predictive power of the nomogram, which were 0.847 in training cohort and 0.823 in testing cohort for 3-year OS, respectively. When excluding patients with advanced CRC, the results show that the prognostic model maintained good performance for OS prediction [C-index: 0.778 (95% CI, 0.72-0.84) and Brier score: 0.072 for 1-year and 0.122 for 3-year OS].
Conclusions
We successfully established a novel biomarker based on transaminase and LDH to guide clinical decision-making for CRC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
This work was supported by the National Natural Sciences Foundation of China (Grants No. 81772499), the National Key R&D Program of China (Grant No. 2017YFC0908204), the Health commission of Hubei Province scientific research project (Grant No. WJ2017Z020, Grant No. WJ2019H121, Grant No. WJ2017M142, Grant No. WJ2021Z001), the Natural Science Foundation of Hubei Province (Grant No. 2019ACA135), Applied Basic Research Program of Wuhan Science and Technology Bureau (Grant No. 2020020601012250).
Disclosure
All authors have declared no conflicts of interest.