治疗前乳酸脱氢酶和白蛋白与碱性磷酸酶比值升高可预测患有糖尿病的头颈癌患者的不良预后和早期终止治疗。

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Camil Ciprian Mireștean, Mihai Cosmin Stan, Roxana Irina Iancu, Dragoș Petru Teodor Iancu, Florinel Bădulescu
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引用次数: 0

摘要

血清乳酸脱氢酶(LDH)活性升高被认为是细胞坏死的标志,也是包括头颈部鳞状细胞癌(HNSCC)在内的几种癌症的代谢组学诊断标志。LDH 是一种参与糖酵解循环的酶,不仅与 HIF-α 和 Myc 等癌基因的激活有关,还与肿瘤增殖和转移等效应有关。血清碱性磷酸酶(ALP)是细胞分化和肿瘤诱导的标志物。白蛋白-碱性磷酸酶比值(AAPR)因其易于获得的动态性和成本效益而成为一种有利的生物标志物。白蛋白与碱性磷酸酶比值升高可能与实体瘤患者总生存期(OS)延长有关。糖尿病(DM)可导致胰岛素抵抗和慢性炎症,并参与癌变、疾病进展和转移的各个方面,从而影响 HNSCC 患者的预后。然而,使用降糖药物(二甲双胍)可通过抑制肿瘤代谢途径产生有益的影响。目前还较少评估 LDH 和 AAPR 在患有 DM 的 HNSCC 患者中的生物标记作用。该研究的目的是评估治疗前血清乳酸脱氢酶(LDH)和白蛋白与碱性磷酸酶比值(AAPR)在预测头颈部肿瘤患者非手术治疗时间和血糖控制方面的预后价值,这些病例选自克拉约瓦县医院肿瘤诊所和肿瘤门诊的数据库。LDH 和 AAPR 均可作为预测治疗反应的治疗前生物标记物,或作为与 DM 相关的 HNC 复杂多参数模型中的预后工具。然而,考虑到短期血糖控制对 LDH 水平的影响,有必要在评估和控制 DM 后再评估这些生物标志物,并将推荐的临界值设定在 0.5 左右。由于病例数量有限,有必要在有更多患者参与的多中心试验中验证结果(表 5,参考文献 50)。关键词:糖尿病、HNC、LDH、AAPR、生物标志物、预测性、头颈部癌症、乳酸脱氢酶、白蛋白与碱性磷酸酶比值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Elevated pretreatment lactate dehydrogenase and albumin-to-alkaline phosphatase ratio predict poor prognosis and early treatment discontinuation in head and neck cancer patients with preexistent diabetes mellitus.

Increased serum lactate dehydrogenase (LDH) activity is considered as a marker of cellular necrosis and serves as a metabolomic diagnostic marker in several types of cancer including head and neck squamous cell carcinoma (HNSCC). LDH, an enzyme involved in the glycolytic cycle, is correlated not only with the activation of oncogenes such as HIF-α and Myc, but also with effects such as tumor proliferation and metastasis. Serum alkaline phosphatase (ALP) is a marker of cell differentiation and tumor induction. Albumin-to-alkaline phosphatase ratio (AAPR) could be an advantageous biomarker due to its easily accessible dynamics and cost-effectiveness. Elevated values of AAPR could be associated with longer overall survival (OS) in cases with solid tumors. Diabetes mellitus (DM) could influence the outcome of patients with HNSCC by contributing to insulin resistance and chronic inflammation, and by being involved in various aspects of carcinogenesis, disease progression and metastasis. However, the use of antihyperglycemic medications (metformin) can have beneficial effects by inhibiting tumor metabolic pathways. The biomarker role of LDH and AAPR in HNSCC patients with DM has been less evaluated. The purpose of the study was to assess the prognostic value of pretreatment serum lactate dehydrogenase (LDH) and albumin-to-alkaline phosphatase ratio (AAPR) in predicting the duration of non-surgical oncological treatment and glycemic control in cases of head and neck cancers patients with DM, including cases selected from the database of the oncology clinic and oncology outpatient clinic of the Craiova County Hospital. Both LDH and AAPR can be used as pre-treatment biomarkers predictive of treatment response, or prognostic tools included in complex multi-parametric models in HNC associated with DM. However, given the impact of short-term glycemic control on the LDH level, it is necessary to evaluate these biomarkers after assessing and controlling for DM, and with the recommended cut-off value set around 0.5. Due to the limited number of cases, it is necessary to validate the results in multicentric trials with a larger number of patients (Tab. 5, Ref. 50). Keywords: diabetes mellitus, HNC, LDH, AAPR, biomarkers, predictive, head and neck cancers, lactate dehydrogenase, albumin-to-alkaline phosphatase ratio.

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来源期刊
CiteScore
2.60
自引率
0.00%
发文量
185
审稿时长
3-8 weeks
期刊介绍: The international biomedical journal - Bratislava Medical Journal – Bratislavske lekarske listy (Bratisl Lek Listy/Bratisl Med J) publishes peer-reviewed articles on all aspects of biomedical sciences, including experimental investigations with clear clinical relevance, original clinical studies and review articles.
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