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

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The prognostic value of preoperative aspartate transaminase to alanine transaminase ratio in urothelial cancer：a systematic review and Meta-analysis

BAO Zhengqing，LIU Zhenhua，XIA Haizhui，WANG Jie，LI Guizhong，WANG Jianwei

（Department of Urology，Beijing Jishuitan Hospital，Capital Medical University，Beijing 100035，China）

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.

KEY WORDS：Meta-analysis; urothelial cancer; Asian population; aspartate transaminase to alanine transaminase ratio; prognosis; upper tract urothelial carcinoma; bladder cancer

摘要：目的 探讨尿路上皮癌（UC）患者术前天冬氨酸转氨酶/丙氨酸转氨酶（AST/ALT）比值与预后的关系。（剩余13940字）