Model Based on Alkaline Phosphatase and Gamma- Glutamyltransferase for Gallbladder Cancer Prognosis

Purpose: To evaluate the prognostic value of alkaline phosphatase (ALP) and gamma-glutamyltransferase(GGT) in gallbladder cancer (GBC). Materials and
Methods: Serum ALP and GGT levels and clinicopathologicalparameters were retrospectively evaluated in 199 GBC patients. Receiver operating characteristic (ROC) curveanalysis was performed to determine the cut-off values of ALP and GGT. Then, associations with overall survivalwere assessed by multivariate analysis. Based on the significant factors, a prognostic score model was established.
Results: By ROC curve analysis, ALP ≥ 210 U/L and GGT ≥ 43 U/L were considered elevated. Overall survivalfor patients with elevated ALP and GGT was significantly worse than for patients within the normal range.Multivariate analysis showed that the elevated ALP, GGT and tumor stage were independent prognostic factors.Giving each positive factor a score of 1, we established a preoperative prognostic score model. Varied outcomeswould be significantly distinguished by the different score groups. By further ROC curve analysis, the simplescore showed great superiority compared with the widely used TNM staging, each of the ALP or GGT alone, ortraditional tumor markers such as CEA, AFP, CA125 and CA199.
Conclusions: Elevated ALP and GGT levelswere risk predictors in GBC patients. Our prognostic model provides infomration on varied outcomes of patientsfrom different score groups.