{"title":"Alkaline Phosphatase: A Prognostic Biomarker in Non-Metastatic Colon Adenocarcinoma Patients - A Single-Centre Study.","authors":"Aminuddin Sheikh, Syed Amir Maqbool, Uzma Raza, Mahay Rookh Asif, Fatima Rizvi, Uzma Bukhari","doi":"10.29271/jcpsp.2025.02.185","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong> To determine the prognostic significance of liver enzymes in colon carcinoma occurrence in country lifestyle and treatment follow-ups and to correlate them with tumour histopathology.</p><p><strong>Study design: </strong>A cross-sectional study. Place and Duration of the Study: Department of Oncology, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan, from May 2023 to July 2024.</p><p><strong>Methodology: </strong>Two hundred non-metastatic colon cancer patients with adenocarcinoma were selected from all provinces and compared with one hundred control subjects. Histopathological patients were grouped based on tumour grade and location. Treatment grouping was according to the prescribed chemotherapy FOLFOX-6 (n = 59), FOLFIRI (n = 82), and FOLFIRI + Bevacizumab (n = 59). Liver enzymes (alkaline phosphatase, alanine transaminase) and CEA colon were estimated by SPSS version 23. ANOVA was used for continuous variable comparison.</p><p><strong>Results: </strong>Alanine transaminase (ALT) and Alkaline phosphatase (ALP) levels were significantly elevated in patients across all tumour grades before treatment (p <0.05). A progressive significant decrease in ALP and carcinoembryonic antigen (CEA) levels was observed in resectable carcinoma patients on chemotherapy across all treatment groups (p <0.05). FOLFOX and FOLFIRI significantly decreased ALT levels in well and moderately differentiated carcinoma patients (p <0.05), whereas adding bevacizumab to FOLFIRI decreased ALT levels in poorly differentiated carcinoma patients, depending on tumour location (p <0.05). ALP levels correlate with symptom duration (p <0.05). Lifestyle was found associated with tumour histological grade.</p><p><strong>Conclusion: </strong>A significant increase in ALP levels with symptom duration and decrease with treatment progress, identifies its significance as a prognostic marker in non-metastatic colon adenocarcinoma patients. Country lifestyle plays a role in colon adenocarcinoma occurrence.</p><p><strong>Key words: </strong>Colonic neoplasm, Alkaline phosphatase, Bevacizumab, Prognostic marker, Alanine transaminase.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"185-190"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.29271/jcpsp.2025.02.185","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Objective: To determine the prognostic significance of liver enzymes in colon carcinoma occurrence in country lifestyle and treatment follow-ups and to correlate them with tumour histopathology.
Study design: A cross-sectional study. Place and Duration of the Study: Department of Oncology, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan, from May 2023 to July 2024.
Methodology: Two hundred non-metastatic colon cancer patients with adenocarcinoma were selected from all provinces and compared with one hundred control subjects. Histopathological patients were grouped based on tumour grade and location. Treatment grouping was according to the prescribed chemotherapy FOLFOX-6 (n = 59), FOLFIRI (n = 82), and FOLFIRI + Bevacizumab (n = 59). Liver enzymes (alkaline phosphatase, alanine transaminase) and CEA colon were estimated by SPSS version 23. ANOVA was used for continuous variable comparison.
Results: Alanine transaminase (ALT) and Alkaline phosphatase (ALP) levels were significantly elevated in patients across all tumour grades before treatment (p <0.05). A progressive significant decrease in ALP and carcinoembryonic antigen (CEA) levels was observed in resectable carcinoma patients on chemotherapy across all treatment groups (p <0.05). FOLFOX and FOLFIRI significantly decreased ALT levels in well and moderately differentiated carcinoma patients (p <0.05), whereas adding bevacizumab to FOLFIRI decreased ALT levels in poorly differentiated carcinoma patients, depending on tumour location (p <0.05). ALP levels correlate with symptom duration (p <0.05). Lifestyle was found associated with tumour histological grade.
Conclusion: A significant increase in ALP levels with symptom duration and decrease with treatment progress, identifies its significance as a prognostic marker in non-metastatic colon adenocarcinoma patients. Country lifestyle plays a role in colon adenocarcinoma occurrence.
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