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Pretreatment Albumin/Globulin Ratio Predicts the Prognosis for Small-Cell Lung Cancer

View Article: PubMed Central - PubMed

ABSTRACT

The pretreatment albumin/globulin ratio (AGR) has been used as a prognostic factor in various cancers. This study aimed to evaluate the predictive value of AGR in small-cell lung cancer (SCLC).

We tested albumin and total proteins in plasma samples from 276 SCLC patients from our cancer center between January 2003 and December 2006. The AGR was defined by the formula: albumin/(total proteins–albumin). The correlation between AGR and overall survival (OS) was examined by Kaplan–Meier and Cox regression methods. For validation, AGR was used to evaluate the prognosis of SCLC in another independent group.

Total 276 patients (testing) and 379 patients (validation) were finally enrolled. The median OS was 15.31 months for testing patients and 15.06 months for validation patients, respectively. We determined 1.29 as the cutoff value by using the biostatistical tool (Cutoff Finder), then the patients in the testing group were classified into 2 groups. Kaplan–Meier curves showed high AGR group had significantly longer OS than low AGR group (P = 0.026). According to multivariate analyses, AGR was an independent prognostic factor for OS of SCLC patients in the testing group (HR, 1.35, 95% CI: 1.01–1.81, P = 0.046). In the validation group, AGR was also verified as a predictive factor for OS (P < 0.001), and the risk of SCLC in the low AGR group was 1.43 times higher than that in the high AGR group (HR, 1.43, 95% CI: 1.05–1.94, P = 0.022).

AGR is an independent prognostic marker in SCLC patients. Furthermore, it could be of great value in the management of SCLC patients.

No MeSH data available.


Related in: MedlinePlus

OS curves comparing patients in the testing group with (A) high AGR level versus low AGR level, (B) high LDH versus low LDH, (C) good PS versus bad PS, and (D) limited disease versus extensive disease. AGR = albumin/globulin ratio, LDH = lactate dehydrogenase, OS = overall survival, PS = performance status.
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Figure 2: OS curves comparing patients in the testing group with (A) high AGR level versus low AGR level, (B) high LDH versus low LDH, (C) good PS versus bad PS, and (D) limited disease versus extensive disease. AGR = albumin/globulin ratio, LDH = lactate dehydrogenase, OS = overall survival, PS = performance status.

Mentions: In the testing group, 63 patients were still alive and 213 patients died at the last follow-up. The median OS of the 276 eligible patients was 15.31 months (IQR 8.20–28.31 months). According to the univariate analysis, AGR (P = 0.026), disease stage (P < 0.001), LDH level (P = 0.001), having TRT (P < 0.001), and ECOG-PS score (P = 0.006) were significantly associated with OS (Table 1, Figure 2). However, there were no significant correlation between OS and age (P = 0.971), gender (P = 0.264), BMI (P = 0.375), chemotherapy regime (P = 0.097), smoking status (P = 0.178), and PCI (P = 0.078) (Table 1). According to the multivariate analysis, we verified the significant factors of univariate survival analysis by testing the independent indexes. The analyses indicated that AGR (P = 0.046), ECOG-PS (P = 0.044), and disease stage (P < 0.001) were the independent predictive factors for OS (Table 3). Patients with lower AGR (<1.29) were estimated to have 1.35 times higher risk of death than those with higher AGR (≥1.29) (HR, 1.35; 95% CI, 1.01–1.81, P = 0.046).


Pretreatment Albumin/Globulin Ratio Predicts the Prognosis for Small-Cell Lung Cancer
OS curves comparing patients in the testing group with (A) high AGR level versus low AGR level, (B) high LDH versus low LDH, (C) good PS versus bad PS, and (D) limited disease versus extensive disease. AGR = albumin/globulin ratio, LDH = lactate dehydrogenase, OS = overall survival, PS = performance status.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998376&req=5

Figure 2: OS curves comparing patients in the testing group with (A) high AGR level versus low AGR level, (B) high LDH versus low LDH, (C) good PS versus bad PS, and (D) limited disease versus extensive disease. AGR = albumin/globulin ratio, LDH = lactate dehydrogenase, OS = overall survival, PS = performance status.
Mentions: In the testing group, 63 patients were still alive and 213 patients died at the last follow-up. The median OS of the 276 eligible patients was 15.31 months (IQR 8.20–28.31 months). According to the univariate analysis, AGR (P = 0.026), disease stage (P < 0.001), LDH level (P = 0.001), having TRT (P < 0.001), and ECOG-PS score (P = 0.006) were significantly associated with OS (Table 1, Figure 2). However, there were no significant correlation between OS and age (P = 0.971), gender (P = 0.264), BMI (P = 0.375), chemotherapy regime (P = 0.097), smoking status (P = 0.178), and PCI (P = 0.078) (Table 1). According to the multivariate analysis, we verified the significant factors of univariate survival analysis by testing the independent indexes. The analyses indicated that AGR (P = 0.046), ECOG-PS (P = 0.044), and disease stage (P < 0.001) were the independent predictive factors for OS (Table 3). Patients with lower AGR (<1.29) were estimated to have 1.35 times higher risk of death than those with higher AGR (≥1.29) (HR, 1.35; 95% CI, 1.01–1.81, P = 0.046).

View Article: PubMed Central - PubMed

ABSTRACT

The pretreatment albumin/globulin ratio (AGR) has been used as a prognostic factor in various cancers. This study aimed to evaluate the predictive value of AGR in small-cell lung cancer (SCLC).

We tested albumin and total proteins in plasma samples from 276 SCLC patients from our cancer center between January 2003 and December 2006. The AGR was defined by the formula: albumin/(total proteins&ndash;albumin). The correlation between AGR and overall survival (OS) was examined by Kaplan&ndash;Meier and Cox regression methods. For validation, AGR was used to evaluate the prognosis of SCLC in another independent group.

Total 276 patients (testing) and 379 patients (validation) were finally enrolled. The median OS was 15.31 months for testing patients and 15.06 months for validation patients, respectively. We determined 1.29 as the cutoff value by using the biostatistical tool (Cutoff Finder), then the patients in the testing group were classified into 2 groups. Kaplan&ndash;Meier curves showed high AGR group had significantly longer OS than low AGR group (P&#8202;=&#8202;0.026). According to multivariate analyses, AGR was an independent prognostic factor for OS of SCLC patients in the testing group (HR, 1.35, 95% CI: 1.01&ndash;1.81, P&#8202;=&#8202;0.046). In the validation group, AGR was also verified as a predictive factor for OS (P&#8202;&lt;&#8202;0.001), and the risk of SCLC in the low AGR group was 1.43 times higher than that in the high AGR group (HR, 1.43, 95% CI: 1.05&ndash;1.94, P&#8202;=&#8202;0.022).

AGR is an independent prognostic marker in SCLC patients. Furthermore, it could be of great value in the management of SCLC patients.

No MeSH data available.


Related in: MedlinePlus