コバヤシ　ヒロヒト   KOBAYASHI Hirohito   小林　博人    所属   医学部 医学科（附属足立医療センター）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The de ritis (aspartate transaminase/alanine transaminase) ratio as a prognosticator in patients with end-stage renal disease-associated renal cell carcinoma.
掲載誌名	正式名：Clinical genitourinary cancer 略　 称：Clin Genitourin Cancer ISSNコード：15587673/19380682
掲載区分	国外
巻・号・頁	18(3),pp.236-240.e1
著者・共著者	IKEDA Takashi†, ISHIHARA Hiroki*, TAKAGI Toshio, FUKUDA Hironori, YOSHIDA Kazuhiko, IIZUKA Junpei, KOBAYASHI Hirohito, OKUMI Masayoshi, ISHIDA Hideki, KONDO Tsunenori*, TANABE Kazunari
発行年月	2020/06
概要	BACKGROUND:The aspartate transaminase (AST)/alanine transaminase (ALT) ratio (ie, the De Ritis ratio) is associated with prognosis in some types of cancers including renal cell carcinoma (RCC). Meanwhile, an effective prognosticator for end-stage renal disease (ESRD)-associated RCC remains unknown. Thus, we investigated the prognostic impact of the AST/ALT ratio in patients with ESRD-associated RCC.PATIENTS AND METHODS:We retrospectively evaluated 243 patients receiving radical nephrectomy for nonmetastatic ESRD-associated RCC. The patients were divided according to the cutoff value of preoperative AST/ALT ratio. Prognostic factors associated with cancer-specific survival (CSS) after radical nephrectomy were analyzed.RESULTS:The maximum Youden index showed that the cutoff value of the AST/ALT ratio was 1.42. The high AST/ALT ratio group (≥ 1.42; n = 88) had a significantly shorter 10-year CSS than the low AST/ALT ratio group (64.3% vs. 87.2%; P = .0027). Multivariate analysis revealed that the AST/ALT ratio was an independent prognostic factor of CSS (hazard ratio [HR], 3.03; P = .0020), together with serum C-reactive protein level (HR, 4.84; P < .0001), pathologic stage (HR, 2.79; P = .0030), and tumor grade (HR, 7.08; P = .0087). Based on these independent factors, the patients were further classified into 3 groups: low (0-1 factor), intermediate (2 factors), and high risk (3-4 factors). The 10-year CSS in the high-risk group was significantly shorter than that of the other groups (68.9% vs. 70.9% vs. 94.4%; P < .0001).CONCLUSION:The AST/ALT ratio can aid in the risk classification of patients with ESRD-associated RCC.
DOI	10.1016/j.clgc.2019.12.012
PMID	31917171