De Ritis Ratio and related Parameters among Breast Cancer Patients in a Southern Nigeria Population

Abstract

De Ritis described the ratio between the serum levels of liver enzymes; aspartate transaminase (AST) and alanine transaminase (ALT). The central role of the liver in metabolism makes it a necessity that it functions optimally during chemotherapeutic administration, hence the consideration of associated parameters in the management of breast cancer. This study was conducted in University of Calabar Teaching Hospital, Calabar. It included 40 cases of pathologically diagnosed breast cancer female patients who were accessing post-operative chemotherapy. Another 40 apparently healthy females drawn from the general population served as controls. Ethical approval and written informed consent were duly sought and obtained. The present study measured the levels of total and conjugated bilirubin as well as the enzyme activities for a spartate aminotransferase, alanine aminotransferase and alkaline phosphatase. Additionally, Unconjugated bilirubin derived from total and conjugated bilirubin as well as De Ritis ratio computed from aspartate aminotransferase and alanine aminotransferase were calculated. Standard colorimetric methods were used to determine the measured parameters, while derived parameters were calculated. The data obtained were analyzed in Statistical Package for Social Sciences (SPSS) using students t-test at 95% confidence level with p-value of ≤ 0.05. Apart from alanine aminotransferase that of the chemotherapy courses showed some observable effect on both derived parameters; Unconjugated Bilirubin and De Ritis ratio. The later showed a stable pattern of increment after commen cement of post-operative chemotherapy. This study indicates that routine assessment of hepatic function and De Ritis ratio should be determined as part of breast cancer management.