Introduction: The activity of butyrylcholinesterase (BChE) in blood reflects liver function\nand has recently been associated with systemic inflammatory response and tumor cachexia. As these\nconditions have been previously linked with pancreatic cancer (PC), the purpose of the present study\nwas to evaluate the prognostic impact of plasma BChE in PC. Methods: Data from 574 consecutive\nPC patients, treated between 2004 and 2018 at a single academic center, was evaluated. The primary\nendpoint was cancer-specific survival (CSS), analyzed by Kaplanâ??Meier curve, and both univariate\nand multivariate Cox proportional models. Results: BChE activity negatively correlated with other\nliver parameters (bilirubin, gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST),\nalkaline phosphatase (ALP), and C-reactive protein (CRP)), and positively correlated with albumin\nlevels, respectively (p < 0.01). In univariate analysis, a low plasma BChE activity was a factor of\npoor CSS (hazard ratio: 1.4, 95% confidence interval: 1.129â??1.754, p = 0.002). In multivariate analysis,\ntumor stage, tumor grade, administration of chemotherapy, bilirubin levels and a low BChE activity\n(hazard ratio: 1.42, 95% confidence interval: 1.10â??1.82; p = 0.006) were identified as independent\nprognostic factors. Conclusion: Decreased activity of BChE in blood plasma predicts shorter survival\ntime in PC patients. Therefore, BChE might be helpful in additional stratification of patients into\ndierent prognostic risk groups.
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