Association between alkaline phosphatase levels and mortality in Chinese patients with colorectal cancer with liver metastases: a retrospective cohort study.

IF 3.9 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Therapeutic Advances in Gastroenterology Pub Date : 2025-01-22 eCollection Date: 2025-01-01 DOI:10.1177/17562848241311114
ZhaoXi Liu, ZiQing Zhang, GuoFang Yu, MingJiang Mo, ChuanYu Xie, DangHan Xu, JieTao Lin, YuChen Zhang, Li Deng, YiChang Luo, YingFeng Huang, Cui Shao
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引用次数: 0

Abstract

Background: Alkaline phosphatase (ALP) is a potential cancer biomarker. However, its prognostic value in patients with colorectal liver metastasis remains unclear.

Objectives: This study aimed to investigate the association between ALP levels and mortality risk in patients with colorectal liver metastases (CRLM), providing insights for enhancing prognostic assessments.

Design: Retrospective cohort study.

Methods: This study included 195 patients with CRLM from a single centre in China. ALP level was the primary exposure variable, with demographic, clinical and pathological factors serving as covariates. Multivariate Cox regression analyses were used to evaluate the impact of ALP on mortality over a 4-year follow-up period. Covariates included the number of liver metastases, T stage, N stage, chemotherapy, tumour location, primary surgery, topical treatment, apolipoprotein A1, targeted therapy, tumour type, CA-199 levels, metastatic surgery, sex, Karnofsky Performance Status and age.

Results: Of 195 enrolled patients, 134 (68.72%) were male, and 61 (31.28%) were female, with ages ranging from January 2008 to December 2019. A total of 147 patients (76.96%) were diagnosed with left hemicolon cancer and 44 (23.04%) with right hemicolon cancer. After adjusting for the covariates, elevated ALP levels were significantly associated with an increased risk of mortality (hazard ratio = 1.24, 95% confidence interval: 1.08-1.43, p = 0.0029). Sensitivity analyses confirmed the robustness of these findings, reinforcing the association across different analytical approaches.

Conclusion: ALP level is a valuable prognostic indicator in patients with CRLM. Integrating ALP measurement into clinical practice may enhance risk stratification and patient management. Future research should explore the role of ALP in broader populations and explore its implications for treatment strategies.

中国结直肠癌肝转移患者碱性磷酸酶水平与死亡率的相关性:一项回顾性队列研究
背景:碱性磷酸酶(ALP)是一种潜在的癌症生物标志物。然而,其在结直肠肝转移患者中的预后价值尚不清楚。目的:本研究旨在探讨结直肠肝转移(CRLM)患者ALP水平与死亡风险之间的关系,为加强预后评估提供见解。设计:回顾性队列研究。方法:本研究纳入来自中国单一中心的195例CRLM患者。ALP水平为主要暴露变量,人口学、临床和病理因素为协变量。采用多变量Cox回归分析评估ALP对4年随访期间死亡率的影响。协变量包括肝转移数量、T分期、N分期、化疗、肿瘤位置、原发手术、局部治疗、载脂蛋白A1、靶向治疗、肿瘤类型、CA-199水平、转移手术、性别、Karnofsky Performance Status和年龄。结果:195例入组患者中,男性134例(68.72%),女性61例(31.28%),年龄范围为2008年1月至2019年12月。左半结肠癌147例(76.96%),右半结肠癌44例(23.04%)。调整协变量后,ALP水平升高与死亡风险增加显著相关(风险比= 1.24,95%可信区间:1.08-1.43,p = 0.0029)。敏感性分析证实了这些发现的稳健性,加强了不同分析方法之间的关联。结论:ALP水平是判断CRLM患者预后的重要指标。将ALP测量纳入临床实践可以加强风险分层和患者管理。未来的研究应探索ALP在更广泛人群中的作用,并探讨其对治疗策略的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Therapeutic Advances in Gastroenterology
Therapeutic Advances in Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.70
自引率
2.40%
发文量
103
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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