Akademik Veri Yönetim Sistemi
ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, cilt.16, sa.2, ss.139-145, 2025 (ESCI)
Aim: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis. This study aimed to evaluate the AST/ALT (De Ritis) ratio as a prognostic biomarker in patients undergoing pancreaticoduodenectomy for PDAC. Material and Methods: Clinical and pathological data of 222 PDAC patients who underwent pancreaticoduodenectomy between November 2010 and December 2018 were retrospectively analyzed. The prognostic value of the De Ritis ratio was assessed using ROC curve analysis. Kaplan-Meier and Cox regression models were used to evaluate their impact on disease-free survival (DFS) and overall survival (OS). Results: 123 patients were analyzed (mean age: 63.48 +/- 10.28 years; 43.1% female). The optimal AST/ALT threshold for survival prediction was 0.66. Patients with a higher De Ritis ratio had significantly shorter median DFS and OS (p < 0.025 and p < 0.048, respectively). Multivariate analysis identified advanced age (p < 0.001), absence of chemotherapy (p < 0.001), recurrence (p = 0.003), prolonged hospital stay (p = 0.016), positive surgical margins (p = 0.012), and high metastatic lymph node count (p = 0.006) as independent risk factors for lower OS. Similar factors also predicted shorter DFS. Discussion: The De Ritis ratio may serve as a prognostic factor in operable PDAC patients. If validated, it could be a simple, cost-effective tool for guiding surgical and neoadjuvant therapy decisions.