Preoperative albumin/globulin ratio has predictive value for patients with laryngeal squamous cell carcinoma.
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ABSTRACT:
SUBMITTER: Chen WZ
PROVIDER: S-EPMC5564641 | biostudies-other | 2017 Jul
REPOSITORIES: biostudies-other
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Project description:In this retrospective analysis, we evaluated associations between albumin to globulin ratio (AGR), clinicopathological characteristics, and survival in 592 patients with localized or locally advanced clear cell renal cell carcinoma (CCRCC) prior to nephrectomy. We found that low AGR was associated with more aggressive tumor behavior; patients with low AGR had poorer overall survival (OS) and cancer-specific survival (CSS) in Kaplan-Meier survival analyses both before and after propensity score matching, which was used to compensate for differences in baseline clinicopathological characteristics. AGR was an independent prognostic factor for both OS (HR: 6.799; 95% CI: 3.215-14.377; P < 0.001) and CSS (HR: 8.806; 95% CI: 3.891-19.928; P < 0.001), and its prognostic value was higher than that of other established inflammation-based prognostic scores. When AGR was incorporated into a prognostic model that included T stage, neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR), the resulting nomogram predicted 3- and 5-year OS in the patients more accurately than when AGR was not included. In conclusion, AGR may be particularly useful for improving clinical outcome predictions for patients with localized or locally advanced CCRCC.
| S-EPMC5564647 | biostudies-other
Project description:Background: Although various inflammation-based indexes in esophageal carcinoma have been documented, but the prognostic value of the albumin-to-globulin ratio(AGR) and its correlation with fibrinogen in resectable ESCC remain unknown. Methods: The levels of pre-treatment serum common acute phase proteins (including CRP, albumin and fribrinogen) were retrospectively analyzed in 447 patients with ESCC who underwent surgical resection at our department. The prognostic value was explored by univariate and multivariate cox hazard analysis. The correlation between AGR and acute phase proteins were also analyzed. Results: Patients with decreased levels of AGR and increased CRP had significantly lower 5-year survival rates than those with higher AGR, not only in the whole ESCC cohort but also in the subgroups stratified according to the disease T, N classifications, and metastasis, whereas the other acute phase proteins were not independent prognostic factors for ESCC. In addition, a lower AGR level was observed more often in patients with a high fibrinogen level than in those with a low fibrinogen level. Spearman's rank correlation analysis revealed that the AGR level presented a negative correlation with the fibrinogen level (r =-0.317, p<0.001). Conclusions: The 5-year survival was shorter in resectable ESCC patients exhibiting decreased pre-treatment AGR and increased CRP. Thus, the serum AGR and CRP may be a clinical prognostic factor for resectable ESCC patients. In addition, a negative correlation was present between the levels of AGR and fibrinogen, the common indexes of acute phase reactants.
| S-EPMC5556647 | biostudies-other
Project description:BackgroundAlthough the C-reactive protein-to-albumin ratio (CAR) can predict poor outcomes in assorted cancers, its prognostic value in oral cavity squamous cell carcinoma (OSCC) remains unclear. We explored the value of preoperative CAR in predicting clinical outcomes in OSCC patients treated with radical surgery.MethodsAll the recommended cutoff values were defined analyzing receiver operating characteristic curves or overall survival (OS). Dichotomization was performed on the basis of optimal CAR cutoff, and we compared the clinicopathological features between groups. Kaplan-Meier analysis was also performed to compare OS curves between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to find the clinical characteristics that were most closely correlated with disease free survival (DFS) and overall survival (OS). A nomogram incorporated CAR and several clinicopathological factors was established to predict prognosis and its accuracy was evaluated using concordance index (c-index).ResultsIn this retrospective study, a total of 326 patients with newly diagnosis of OSCC and received primary surgery between 2008 and 2017 were enrolled. Through the executed ROC curve analyses, the optimal CAR cutoff derived was 0.195 (area under the curve = 0.718, p < 0.001), with this cutoff exhibiting a discrimination ability superior to that of other inflammation-based prognostic scores after comparing the area under curves. Multivariate analysis demonstrated that CAR (?0.195/<0.195) was associated with OS (hazard ratio 3.614; 95% CI [1.629-8.018]; p = 0.002) and DFS (hazard ratio 1.917; 95% CI [1.051-3.863]; p = 0.029). Kaplan-Meier analysis and log rank test revealed a significant difference in DFS and OS curves between patients with low CAR (<0.195) and those with high CAR (?0.195; both p < 0.001). The c-index of the nomogram based on TNM system alone was 0.684 and could be increased to 0.801 if CAR and other clinicopathological factors were included.ConclusionsPreoperative CAR could constitute an independent prognostic indicator for OS and DFS prediction in OSCC patients treated with curative surgery. The established nomogram that incorporated CAR and prognostic factors might increase the accuracy of prognostic prediction for patients with OSCC.
| S-EPMC7304427 | biostudies-literature
Project description:Background. The pretreatment albumin and globulin ratio (AGR) was an inflammation-associated factor which was related to the overall survival in various malignancies. The aim of this study was to evaluate the prognostic value of AGR in patients with gastric cancer. Method. This retrospective study included 862 cases pathologically diagnosed with gastric cancer. All patients were randomly divided into the testing group (431 cases) and validation group (431 cases). The relationships of AGR with clinicopathologic characteristics and prognosis were analyzed by Kaplan-Meier and Cox regression methods. Results. In the testing group, the median overall survival was 26.90 months and the cutoff value of AGR was 1.50 based on R language. Kaplan-Meier analysis showed that lower AGR was correlated with poorer overall survival. Multivariate analysis demonstrated that AGR was an independent prognostic factor for overall survival (HR: 0.584, 95% CI = 0.351-0.973, and p = 0.039). In the validation group, the median overall survival was 24.10 months. Lower AGR (≤1.50) also had a significantly poorer overall survival by Kaplan-Meier analysis. According to multivariate analysis, the AGR was also confirmed to be an independent prognostic factor for overall survival (HR: 0.578, 95% CI = 0.373-0.897, and p = 0.015). Conclusions. Our study suggested that the pretreatment AGR could be a prognostic biomarker for overall survival in patients with gastric cancer.
| S-EPMC5382292 | biostudies-literature
Project description:Purpose: The purpose of the present study was to investigate the prognostic value of inflammatory and nutritional-based scores, including the albumin/fibrinogen ratio (AFR) and albumin/globulin ratio (AGR), in patients with esophageal squamous cell carcinoma (ESCC). Methods: The medical records of 641 patients with resectable ESCC from our institution were retrospectively analyzed. The preoperative AFR and AGR were investigated based on serum albumin, globulin and plasma fibrinogen levels. X-tile software, Kaplan-Meier survival curves and Cox proportional hazard models were performed to identify their prognostic value. The predictive accuracy was evaluated by the concordance index (C-index), calibration plots, and decision curve analysis (DCA). Results: The optimal cutoff values were 15.3 and 1.8 for AFR and AGR, respectively. Univariate survival analysis identified age, smoking history, tumor size, pT status, pN status, NLR, PLR, fibrinogen, albumin, AFR, and AGR as factors associated with overall survival. Multivariate analysis indicated that preoperative AFR (HR: 0.690, 95% CI = 0.495~0.960, P = 0.028), rather than other inflammation- and nutrition-based scores, was an independent predictor of overall survival. The C-index of the predicted nomogram containing AFR (C-index = 0.677) was higher than that of the nomogram without AFR (C-index = 0.656). The calibration curves showed that the predictive abilities were consistent with the actual observation results. Moreover, compared with the traditional staging system, the results of DCA showed that the nomogram had superior predictive ability and higher clinical utility. Conclusion: Our preliminary study suggested that a low preoperative AFR might be a novel and valuable predictor of poor prognosis in patients with ESCC, which may be helpful for prognosis assessment, patient counseling, and therapeutic modality selection.
| S-EPMC8247378 | biostudies-literature
Project description:ObjectiveTo evaluate whether pretreatment albumin-globulin ratio (AGR) can be used as a biomarker for predicting the prognosis of patients with urothelial carcinoma (UC).MethodsWe systematically searched PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Google Scholar and Cochrane Library; the search time was up to May 2022. Stata 16.0 was used for data processing and statistical analysis.ResultsWe identified 12 studies with 5,727 patients from 317 unique citations during the meta-analysis. Our results suggested that a low AGR before treatment was significantly associated with poor overall survival (OS) [hazard ratio (HR) = 1.99, 95% confidence interval (CI) = 1.45-2.75, P < 0.001], cancer-specific survival (CSS) [HR=2.01, 95% CI = 1.50-2.69, P < 0.001] and recurrence-free survival (RFS) [HR=1.39, 95% CI = 1.12-1.72, P = 0.002]. Furthermore, we defined different subgroups according to ethnicity, cancer type, cut-off value, sample size and stage. Similar prognostic outcomes for OS and CSS were observed in most subgroups. However, for subgroup of stage, the low pretreatment AGR only predicted the poor survival of patients with non-metastatic UC.ConclusionOur meta-analysis revealed that the AGR before treatment could be used as a predictive biomarker to indicate the prognosis of UC patients during clinical practice, especially in patients with non-metastatic UC.
| S-EPMC9424645 | biostudies-literature
Project description:Background: Both nutritional status and coagulation function are closely associated with prognosis in patients with bladder cancer (BC). This study aimed to investigate the prognostic value of albumin-to-fibrinogen ratio (AFR) for BC patients underwent radical cystectomy (RC) or transurethral resection of bladder tumor (TURBT), and develop predictive nomograms based on AFR. Methods: We retrospectively collected medical records of 358 BC patients who underwent RC or TURBT between January 2012 and December 2018. The whole cohort was divided into the training (215 patients, 60.06%) and validation cohorts (143 patients, 39.94%) based on surgery dates. The training cohort was applied to select characteristics and construct nomograms, while the validation cohort was used to verify the nomograms independently. Endpoints of the current study included overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). Prognostic values of AFR and other characteristics were evaluated using univariate and multivariate Cox regression analyses and compared using the concordance-index (C-index). Nomograms for OS, DSS and DFS were constructed based on both-directional stepwise Cox proportional hazards regression analysis and evaluated by the receiver operating characteristic (ROC) curve, the C-index and calibration plot. Results: In whole cohort, 86 patients (24.02%) were classified into low AFR group and had worse OS (hazard ratio [HR]: 4.079, 95% confidence interval [CI]: 2.085-7.982, P < 0.001), DSS (HR: 3.012, 95% CI: 1.302-6.966, P = 0.010) and DFS (HR: 1.863, 95% CI: 1.204-2.883, P = 0.005) compared to BC patients in high AFR group. Meanwhile, the AFR processed better prognostic power than albumin and fibrinogen, individually. Multivariate Cox analysis indicated that AFR was an independent prognostic factor for OS (HR: 2.601, 95% CI: 1.057-6.395, P = 0.037) and DFS (HR: 1.971, 95% CI: 1.049-3.703, P = 0.035). Novel nomograms, incorporating AFR, tumor grade and tumor multifocality, were constructed and successfully validated for predictions of OS, DSS and DFS in BC. Conclusions: Preoperative AFR was identified as an independent prognostic predictor for OS and DFS of BC patients underwent surgery. The nomograms incorporating AFR provided accurate predictions for OS, DSS and DFS, which could help urologists in better clinical decision-making.
| S-EPMC8408123 | biostudies-literature
Project description:BackgroundInflammation plays a pivotal role in the pathogenesis of chronic kidney disease (CKD). Significant association between serum albumin-to-globulin (AG) ratio and inflammation led us to investigate the prognostic value of serum AG ratio for incident CKD.MethodsThe predictive value of serum AG ratio, white blood cell (WBC), and C-reactive protein (CRP) for CKD development was assessed in 8,057 non-CKD participants from a community-based, prospective cohort in Korea. Serum AG ratio was calculated by following equation: serum albumin (g/L)/[serum total protein (g/L)-serum albumin (g/L)]. Incident CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or proteinuria of more than 1+ on dipstick.ResultsMedian serum AG ratio was 1.38 (interquartile range, 1.28-1.52). During a mean follow-up duration of 9.1±3.7 years, 1,732 participants (21.5%) developed CKD. In a multivariable Cox analysis, a low serum AG ratio was significantly associated with an increased risk of incident CKD (Q1, serum AG ratio <1.26: hazard ratio [HR] = 1.651, 95% confidence interval [CI] = 1.406-1.938, Q5 as reference; per 0.2 decrease, HR = 1.170, 95% CI = 1.109-1.234). Serum AG ratio was the only indicator to improve the predictability of CKD development (net reclassification index = 0.158, P <0.001; integrated discrimination improvement = 0.005, P <0.001), compared with WBC or CRP.ConclusionsThis study demonstrates that low serum AG ratio is an independent predictor for CKD development and exhibits a stronger predictive value than other inflammatory markers. These findings suggest that determining serum AG ratio may be more valuable for predicting adverse kidney outcomes in non-CKD populations.
| S-EPMC7467286 | biostudies-literature
Project description:BackgroundThe study aims to explore diagnostic value of albumin/fibrinogen ratio (AFR) and C-reactive protein (CRP)/albumin (ALB)/globulin (GLO) ratio (CAGR) for periprosthetic joint infection (PJI).MethodsA retrospective analysis was conducted on clinical data collected from 190 patients who had joint replacement surgery in Qilu Hospital of Shandong University (Qingdao), from January 2017 to December 2022. Based on the occurrence of PJI after surgery, patients were divided as an infection group (10 cases) and non-infection group (180 cases). Diagnostic indicators were analyzed, univariate and multivariate logistic regression analyses were further performed to identify factors related to PJI. Sensitivity and specificity of AFR and CAGR, both individually and in combination, were calculated using ROC curves, and their diagnostic performance was compared based on the area under the curve (AUC).ResultsLevels of CRP, ESR, FIB, GLO, and CAGR were significantly higher in the infection group than in non-infection group (P < 0.05). Levels of ALB and AFR were significantly lower in infection group (P < 0.05). Multivariate logistic regression analysis reviewed that CRP (OR = 3.324), ESR (OR = 2.118), FIB (OR = 3.142), ALB (OR = 0.449), GLO (OR = 1.985), AFR (OR = 0.587), and CAGR (OR = 2.469) were factors influencing PJI (P < 0.05). The AUC for AFR and CAGR in diagnosing PJI were 0.739 and 0.780, while AUC for their combined detection was 0.858.ConclusionAbnormal levels of AFR and CAGR are associated with PJI, and their combined use has certain diagnostic value for PJI.
| S-EPMC10726739 | biostudies-literature
Project description:The albumin/globulin ratio (AGR) has been widely reported to be a potential predictor of prognosis in digestive system cancers (DSCs), but convincing conclusions have not been made. Therefore, herein, we performed a meta-analysis of relevant studies regarding this topic to evaluate the prognostic value of AGR in patients with DSCs. Three databases, including PubMed, EMBase, and Web of science, were searched comprehensively for eligible studies through September 8, 2017. The outcomes of interest included overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS). In our meta-analysis, pooled analysis of 13 studies with 9269 patients showed that a low AGR was significantly correlated with poor OS (HR = 1.94; 95% CI: 1.57-2.38; P <0.001). Five studies with 6538 participants involved DFS, and our pooled analysis of these studies also demonstrated that there was a significant association of a low AGR with worse DFS (HR = 1.49; 95% CI: 1.10 to 2.00; P < 0.001). In addition, only 2 studies referred to CSS, and we also detected a significant relationship between a low AGR and worse CSS from the results of our meta-analysis. In summary, a low pretreatment AGR was related to unfavorable survival in human digestive system cancers. A low pretreatment AGR may be a useful predictive prognostic biomarker in human digestive system cancers.
| S-EPMC5754056 | biostudies-literature