The prognostic value of preoperative aspartate transaminase to alanine transaminase ratio in urothelial cancer: a systematic review and Meta-analysis
10.3969/j.issn.1009-8291.2025.02.014
- VernacularTitle:术前天冬氨酸转氨酶/丙氨酸转氨酶比值预测尿路上皮癌预后的Meta分析
- Author:
Zhengqing BAO
1
;
Zhenhua LIU
1
;
Haizhui XIA
1
;
Jie WANG
1
;
Guizhong LI
1
;
Jianwei WANG
1
Author Information
1. Department of Urology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
- Publication Type:Journal Article
- Keywords:
Meta-analysis;
urothelial cancer;
Asian population;
aspartate transaminase to alanine transaminase ratio;
prognosis;
upper tract urothelial carcinoma;
bladder cancer
- From:
Journal of Modern Urology
2025;30(2):161-167
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the association between preoperative aspartate transaminase to alanine transaminase (AST/ALT) ratio and the outcomes of urothelial cancers. Methods: After a systematic search of Web of Science，PubMed and Embase before Aug.2024，14 studies were included in the Meta-analysis.The hazard ratios (HRs) with 95% confidence interval (CI) for overall survival (OS)，cancer-specific survival (CSS)，and recurrence-free survival (RFS) were analyzed using STATA 15.0 software. Results: The Meta-analysis included a total of 8190 patients.Urothelial cancer patients with an elevated preoperative AST/ALT ratio had worse OS (HR=1.92，95% CI：1.38-2.67，P<0.001)，CSS (HR=2.12，95% CI：1.48-3.05，P<0.001)，and RFS (HR=1.63，95% CI：1.27-2.10，P<0.001).In subgroup analyses，preoperative AST/ALT ratio had a better predictive value for OS，CSS，and RFS in patients with bladder cancer than in patients with upper tract urothelial carcinoma，and a better predictive value in Asian population than in Caucasian population (P<0.001). Conclusion: A high preoperative AST/ALT ratio is associated with poor OS，CSS and RFS in urothelial cancers，particularly among the Asian population.
