Cholinesterase is Associated With Prognosis and Response to Chemotherapy in Advanced Gastric Cancer

医学 内科学 化疗 单变量分析 生物标志物 多元分析 胃肠病学 癌症 逻辑回归 胆碱酯酶 无进展生存期 转移 肿瘤科 生物化学 化学
作者
Yanzhi Bi,Junling Zhang,Zeng Dan,Lili Chen,Wei Ye,Qin Yang,Yang Ling
出处
期刊:Pathology & Oncology Research [Springer Science+Business Media]
卷期号:27 被引量:10
标识
DOI:10.3389/pore.2021.580800
摘要

Background: Cholinesterase (CHE) is a routine serum biomarker in gastric cancer (GC). However, little research has been done on its clinical value in advanced GC. In addition, it is not clear whether it can be used as biomarker for the response and prognosis of advanced GC patients. Methods: Between Jan. 2013 and Dec. 2016, a total of 150 patients with advanced GC treated with first-line chemotherapy were admitted to Changzhou Tumor Hospital Affiliated to Soochow University. We retrospectively identified serum CHE level on the day before chemotherapy and at the end of chemotherapy and abstracted clinicopathologic features and treatment outcomes. Univariate and multivariate survival analyses were performed to assess the relationship between serum CHE levels and progression-free survival (PFS) and overall survival (OS). Results: A total of 150 advanced GC patients were included and divided into serum level ≥5,000 IU/L and serum level <5,000 IU/L. CHE level lower than 5,000 IU/L was associated with poorer PFS (HR, 1.60; 95% CI, 1.141–2.243; p = 0.006), poorer OS (HR, 1.76; 95% CI, 1.228–2.515; p = 0.002) and trend of poorer response (HR, 0.56; 95% CI, 0.272–1.129; p = 0.104). In univariate and multivariate logistic regression analysis, only liver metastasis and PS score were significantly associated with objective response ( p < 0.05). The medium PFS was 8.0 months in patients with post-treatment CHE increased vs. 3.8 months in patients with CHE decreased after chemotherapy (HR, 1.82; 95% CI 1.28–2.57; p = 0.0002). The medium OS was 13.1 months in patients with increased post-treatment CHE vs. 8.1 months in patients with decreased post-treatment CHE (HR, 1.87; 95% CI 1.29–2.71; p = 0.0002). Conclusion: Advanced GC with CHE levels below 5,000 IU/L was significantly associated with poor PFS and OS. The results suggested that CHE analysis before chemotherapy was a promising prognostic marker for advanced GC.
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