Can liver-associated parameters serve as prognostic factors in pancreatic cancer? – A retrospective analysis of a large-capacity centre

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI:10.1016/j.advms.2026.02.001

Marta Fudalej , Anna Badowska-Kozakiewicz , Andrzej Deptała

{"title":"Can liver-associated parameters serve as prognostic factors in pancreatic cancer? – A retrospective analysis of a large-capacity centre","authors":"Marta Fudalej , Anna Badowska-Kozakiewicz , Andrzej Deptała","doi":"10.1016/j.advms.2026.02.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>The study aimed to analyze pretreatment liver parameters among patients with pancreatic cancer (PC) and determine their prognostic value.</div></div><div><h3>Materials/methods</h3><div>A total of 310 patients with a confirmed PC diagnosis were screened for available liver parameters in routine blood sample analysis before the first round of chemotherapy. The assessed parameters included alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, alkaline phosphatase (ALP), and albumin. Two indices were calculated: AST/ALT and albumin/ALP ratios. Statistical analyses were performed utilizing appropriate tests.</div></div><div><h3>Results</h3><div>An elevated AST/ALT ratio was associated with more than a twofold increase in mortality risk (HR = 2.13, 95% CI 1.40–3.24, p < 0.001); however, this association did not remain statistically significant after adjustment for age and disease stage in the multivariate analysis. The calculated AST/ALT ratio cut-off did not effectively distinguish between patients with different tumor characteristics. Therefore, stratification based on this ratio may not be informative in PC. Pretreatment albumin and total bilirubin levels significantly predicted mortality (albumin value > 4.31 g/dL: HR = 0.49, 95% CI 0.30–0.80, p = 0.004, and total bilirubin >0.77 mg/dL: HR = 2.30, 95% CI 1.67–3.17, p < 0.001) and helped classify patients. Neither ALP alone nor the albumin/ALP ratio appeared to serve as a valuable prognostic factor.</div></div><div><h3>Conclusions</h3><div>Our study further confirmed that liver function can influence the prognosis of patients with PC. The exact values of liver parameters in clinical practice should be established through a large, prospective, multicenter study.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 1","pages":"Pages 46-55"},"PeriodicalIF":2.5000,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in medical sciences","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1896112626000040","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

The study aimed to analyze pretreatment liver parameters among patients with pancreatic cancer (PC) and determine their prognostic value.

Materials/methods

A total of 310 patients with a confirmed PC diagnosis were screened for available liver parameters in routine blood sample analysis before the first round of chemotherapy. The assessed parameters included alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, alkaline phosphatase (ALP), and albumin. Two indices were calculated: AST/ALT and albumin/ALP ratios. Statistical analyses were performed utilizing appropriate tests.

Results

An elevated AST/ALT ratio was associated with more than a twofold increase in mortality risk (HR = 2.13, 95% CI 1.40–3.24, p < 0.001); however, this association did not remain statistically significant after adjustment for age and disease stage in the multivariate analysis. The calculated AST/ALT ratio cut-off did not effectively distinguish between patients with different tumor characteristics. Therefore, stratification based on this ratio may not be informative in PC. Pretreatment albumin and total bilirubin levels significantly predicted mortality (albumin value > 4.31 g/dL: HR = 0.49, 95% CI 0.30–0.80, p = 0.004, and total bilirubin >0.77 mg/dL: HR = 2.30, 95% CI 1.67–3.17, p < 0.001) and helped classify patients. Neither ALP alone nor the albumin/ALP ratio appeared to serve as a valuable prognostic factor.

Conclusions

Our study further confirmed that liver function can influence the prognosis of patients with PC. The exact values of liver parameters in clinical practice should be established through a large, prospective, multicenter study.

查看原文本刊更多论文

肝脏相关参数能否作为胰腺癌的预后因素？-对一个大容量中心进行回顾性分析。

目的：本研究旨在分析胰腺癌（PC）患者的预处理肝脏参数，并确定其预后价值。材料/方法：在第一轮化疗前，对310例确诊为PC的患者进行常规血样本分析，筛选可获得的肝脏参数。评估参数包括丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素、碱性磷酸酶（ALP）和白蛋白。计算AST/ALT和白蛋白/ALP比值。采用适当的测试进行统计分析。结果：AST/ALT比值升高与死亡风险增加两倍以上相关（HR = 2.13, 95% CI 1.40-3.24, p < 0.001）；然而，在多变量分析中调整年龄和疾病分期后，这种关联在统计学上并不显著。计算出的AST/ALT比值临界值不能有效区分不同肿瘤特征的患者。因此，基于该比率的分层在PC中可能不具有信息性。预处理白蛋白和总胆红素水平显著预测死亡率（白蛋白值> 4.31 g/dL: HR = 0.49, 95% CI 0.30-0.80, p = 0.004，总胆红素> 0.77 mg/dL: HR = 2.30, 95% CI 1.67-3.17, p < 0.001），并有助于分类患者。单独的ALP和白蛋白/ALP比值似乎都不能作为有价值的预后因素。结论：本研究进一步证实肝功能可影响PC患者的预后。临床实践中肝脏参数的确切值应该通过大规模、前瞻性、多中心的研究来确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.