Aminotransaminases, including aspartate aminotransaminase (AST) and alanine aminotransaminase (ALT), are strongly involved in cancer cell metabolism and have been associated with prognosis in different types of cancer. The purpose of the present study was to evaluate the prognostic significance of the pre-treatment AST/ALT ratio in a large European cohort of patients with oral and oropharyngeal squamous cell cancer (OOSCC). Data from 515 patients treated for OOSCC at a tertiary academic center from 2000–2017 were retrospectively analyzed. Levels of AST and ALT were measured prior to the start of treatment. Uni- and multivariate Cox regression analyses were applied to evaluate the prognostic value of the AST/ALT ratio for cancer-specific survival (CSS) and overall survival (OS), survival rates were calculated. Univariate analyses showed a significant association of the AST/ALT ratio with CSS (hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.38–2.12; p < 0.001) and OS (HR 1.69, 95% CI 1.41–2.02; p < 0.001). In multivariate analysis, the AST/ALT ratio remained an independent prognostic factor for CSS and OS (HR 1.45, 95% CI 1.12–1.88, p = 0.005 and HR 1.42, 95% CI 1.14–1.77, p = 0.002). Applying receiver operating characteristics (ROC) curve analysis, the optimal cut-off level for the AST/ALT ratio was 1.44, respectively. In multivariate analysis, an AST/ALT ratio >1.44 was an independent prognostic factor for poor CSS and OS (HR 1.64, 95% CI 1.10–2.43, p = 0.014 and HR 1.55, 95% CI 1.12–2.15; p = 0.008). We conclude that the AST/ALT ratio is a prognostic marker for survival in OOSCC patients and could contribute to a better risk stratification and improved oncological therapy decisions.

中文翻译：

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AST / ALT（De Ritis）比值可预测口腔和口咽癌患者的生存率

包括天冬氨酸氨基转氨酶（AST）和丙氨酸氨基转氨酶（ALT）在内的氨基转氨酶与癌细胞的代谢密切相关，并与不同类型癌症的预后相关。本研究的目的是评估在欧洲大量口腔和口咽鳞状细胞癌（OOSCC）患者中治疗前AST / ALT比的预后意义。回顾性分析了2000年至2017年间在高等学术中心接受OOSCC治疗的515例患者的数据。在治疗开始前先测量AST和ALT水平。应用单变量和多变量Cox回归分析评估AST / ALT比对癌症特异性生存期（CSS）和总体生存期（OS）的预后价值，计算生存率。p <0.001）和OS（HR 1.69，95％CI 1.41–2.02；p <0.001）。在多变量分析中，AST / ALT比仍然是CSS和OS的独立预后因素（HR 1.45，95％CI 1.12-1.88，p = 0.005，HR 1.42，95％CI 1.14-1.77，p = 0.002）。应用接收器工作特性（ROC）曲线分析，AST / ALT比的最佳截止水平分别为1.44。在多变量分析中，AST / ALT比> 1.44是CSS和OS不良的独立预后因素（HR 1.64，95％CI 1.10–2.43，p = 0.014，HR 1.55，95％CI 1.12–2.15；p= 0.008）。我们得出的结论是，AST / ALT比是OOSCC患者生存的预后指标，并且可能有助于更好的风险分层和改善的肿瘤治疗决策。