Zie ook literatuurlijst niet-toxische middelen, voeding en voedingsstoffen en minder belastende behandelingen specifiek bij nierkanker samengesteld door arts-bioloog drs. Engelbert Valstar.

29 juni 2020: Bron: Targeted Oncology volume 15, pages347–356(2020)

γ-Glutamyltransferase (GGT)  (Gammaglutamyltransferase) is een enzymmarker (eiwitmarker) van zogeheten oxidatieve stress. Verhoogde bloedwaarden van GGT is gekoppeld aan slechte overleving bij verschillende vormen van kanker. Zo ook blijkt dit op te gaan voor patiënten met uitgezaaide gevorderde nierkanker.

Uit een Japanse retrospectieve studie van totaal 156 patiënten met uitgezaaide nierkanker (mRCC) die tussen april 2008 en januari 2019 een eerstelijns- of tweedelijns TKI-therapie kregen, onderzochten de onderzoekers wat de voorspellende rol voor overall overleving is geweest van bloedwaarde γ-Glutamyltransferase (GGT)  en om te onderzoeken of overexpressie van GGT in RCC-cellen heeft bijgedragen tot verhoging van serum GGT met behulp van chirurgisch verwijderde RCC-kankerweefsel.

De mediane overall overleving (OS) was respectievelijk 16,0 maanden en 36,8 maanden bij patiënten met verhoogde GGT-spiegels en zonder verhoogde GGT (P <.001).
Bij een multivariabele analyse was een verhoogde bloed-GGT een onafhankelijke ongunstige prognostische factor (HR, 4,04; P <.001), samen met hoge concentraties neutrofielen (HR, 2,06; P = .041), lage albumine (HR, 2,00, P = 0,006), hoge LDH (HR, 2,68; P <0,001) en hoge De Ritis-ratio (AST/ALT) (HR, 1,97; P = 0,004). 

Het studierapport: Impact of Serum γ-Glutamyltransferase on Overall Survival in Patients with Metastatic Renal Cell Carcinoma in the Era of Targeted Therapy is tegen betlaing in te zien.

Hier het abstract van de studie: 

Impact of Serum γ-Glutamyltransferase on Overall Survival in Patients with Metastatic Renal Cell Carcinoma in the Era of Targeted Therapy

Abstract

Background

γ-Glutamyltransferase (GGT) is a marker of oxidative stress. Elevated serum GGT is linked to poor survival in various malignancies; however, there are no data on metastatic renal cell carcinoma (mRCC). Additionally, GGT expression in cancer tissues remains largely unknown.

Objective

The present study was designed to determine the prognostic role of serum GGT in patients with mRCC and the association between systemic and local GGT levels.

Patients and Methods

Pretherapeutic serum GGT and other clinicopathological parameters were retrospectively compared with overall survival (OS) in 146 consecutive patients with mRCC receiving tyrosine kinase inhibitor therapy. GGT expression was analyzed in 65 resected specimens using immunohistochemistry.

Results

A total of 82 patients (56%) died during the follow-up period (median 34.9 months). Median OS was 16.0 months and 36.8 months in patients with elevated GGT levels and without elevated GGT, respectively (P < 0.001). On multivariable analysis, elevated serum GGT was an independent adverse prognostic factor (hazard ratio 4.04, P < 0.001), together with high neutrophils (HR 2.06, P = 0.041), low albumin (HR 2.00, P = 0.006), high lactate dehydrogenase (HR 2.68, P < 0.001), and high De Ritis ratio (HR 1.97, P = 0.004). Preoperative serum GGT levels were 29, 48, and 109 U/l in patients whose renal cancer cells showed negative to weak, moderate, and strong GGT expression, respectively (P = 0.004).

Conclusions

Elevated serum GGT was an unfavorable prognostic factor in mRCC, and overexpression of GGT in renal cancer cells might be responsible for elevation of serum GGT.

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Contributions

Each author qualifies for authorship based on substantial contributions. Conception and design: KT, TY, KI, and FK. Acquisition of data: KT, TY, KI, and GA. Analysis and interpretation of data: KT. Drafting of the manuscript: KT. Critical revision of the manuscript for important intellectual content: KT, TY, FK, and PGB. Statistical analysis: KT. Obtaining funding: TY. Administrative, technical, or material support: JY. Supervision: TY and JY. Other: none.

Corresponding author

Correspondence to Kosuke Takemura.

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Funding

Dr. Yuasa has been funded by the Smoking Research Foundation and JSPS KAKENHI Grant Number 16K11035; however, there was no direct or indirect commercial incentive associated with publishing this article.

Conflict of interest

Kosuke Takemura, Takeshi Yuasa, Kentaro Inamura, Gulanbar Amori, Fumitaka Koga, Philip G. Board, and Junji Yonese declare that they have no conflicts of interest that might be relevant to the contents of this article.

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Takemura, K., Yuasa, T., Inamura, K. et al. Impact of Serum γ-Glutamyltransferase on Overall Survival in Patients with Metastatic Renal Cell Carcinoma in the Era of Targeted Therapy. Targ Oncol 15, 347–356 (2020). https://doi.org/10.1007/s11523-020-00719-9

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