Prognostic evaluation value of serum ALT/AST ratio combined with albumin score in gastric cancer patients undergoing chemotherapy

CHEN Xia; WU Linxia; LI Tao; YANG Lingling

doi:10.3969/j.issn.1674-4136.2025.02.006

Abstract：Objective To explore the prognostic evaluation value of serum alanine aminotransferase(ALT)to aspartate aminotransferase(AST)ratio(LSR)combined with albumin(ALB)score in gastric cancer patients undergoing chemotherapy.Methods A total of 150 gastric cancer patients who received chemotherapy in Nantong Cancer Hospital from January 2021 to January 2023 were enrolled as the research subjects.Clinical data of the patients were collected,and the patients were followed up for 24 months to collect follow-up data.The receiver operating characteristic(ROC)curve was used to analyze the optimal cut-off values of serum ALT/AST and ALB on admission.The research subjects were divided into group 0,group 1,and group 2 according to the LSR-ALB score.Clinical data of patients in each group were compared.Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the prognostic impact and evaluation value of the LSR-ALB score on the prognosis of gastric cancer patients undergoing chemotherapy.Results The results of ROC curve analysis showed that the area under the curve AUC of LSR was 0.653(95%CI:0.621-0.807),and the optimal cut-off value was 1.37.The AUC of ALB was 0.626(95%CI:0.601-0.760),and the optimal cut-off value was 39 g/L.The combined AUC of LSR and ALB was 0.728(95%CI:0.684-0.801).This indicated that the combined prediction efficiency of LSR and ALB for the prognosis of gastric cancer patients undergoing chemotherapy was superior to that of LSR or ALB alone.According to the LSR-ALB score,the research subjects were included in the 0-score group(n=42),1-score group(n=67),and 2-score group(n=41).There were statistically significant differences in age,tumor diameter,tumor stage,degree of differentiation,number of organ metastases,liver metastasis,peritoneal metastasis,NLR,ChE,and chemotherapy regimen among the three groups(P＜0.05).The median follow-up time of 150 patients was18.5 months.During the follow-up period,128 patients died(accounting for 85.33%),and the median overall survival(OS)was 10.2 months.There were no lost-to-follow-up cases.The results of Kaplan-Meier survival analysis showed that the median OS of the 0-score group was 12.6 months,that of the 1-score group was 10.1 months,and that of the 2-score group was 8.3 months.There were statistically significant differences in median OS among the three groups(P＜0.05).The overall survival rate of the 0-score group was 26.19%,that of the 1-score group was 14.93%,and that of the 2-score group was 2.44%.There were statistically significant differences in overall survival rate among the three groups(P＜0.05).The results of multivariate COX analysis showed that an LSR-ALB score of 2,stageⅣtumor,more than 1 organ metastasis,liver metastasis,low ChE,and non-first-line chemotherapy regimen were independent risk factors affecting the OS of gastric cancer patients undergoing chemotherapy.Conclusions The serum LSR-ALB score is helpful for evaluating the prognosis of gastric cancer patients undergoing chemotherapy and can be used as a reference index for their prognosis.