Albumin to gamma-glutamyltransferase ratio as a prognostic indicator in intrahepatic cholangiocarcinoma after curative resection.
Albumin to gamma-glutamyltransferase ratio as a prognostic indicator in intrahepatic cholangiocarcinoma after curative resection.
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DOI：
10.18632/oncotarget.14530
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发表时间：
2017-02-21
期刊：
影响因子：
--
通讯作者：
Zhang BH
中科院分区：
文献类型：
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作者：
Jing CY;Fu YP;Shen HJ;Zheng SS;Lin JJ;Yi Y;Huang JL;Xu X;Zhang J;Zhou J;Fan J;Ren ZG;Qiu SJ;Zhang BH
肝内胆管细胞癌（ICC）的预后仍然很差，而ICC患者根治性切除后的生存预测模型是有限的。在此，我们建立了一个新的炎症评分，从术前白蛋白γ-谷氨酰转移酶的比例（AGR），并评估其预后意义的ICC患者接受根治性切除。AGR的预后价值进行了回顾性研究，在一个队列包括206 ICC患者根治性切除术。根据一致性指数（C指数），将AGR的预测性能与其他基于炎症的评分和血清学肿瘤标志物进行比较。此外，将AGR纳入肿瘤淋巴结转移（TNM）分期系统的预后列线图，以实现更好的区分能力。AGR的最佳临界值为0.6。多变量分析显示AGR是总生存期（OS; P = 0.003）和无复发生存期（RFS; P = 0.046）的独立预测因子。AGR的C指数在预测OS和RFS方面上级其他基于炎症的评分和血清学肿瘤标志物。与单独的TNM分期系统相比，所建立的列线图显示出更高的预测准确性。这些结果表明AGR是行根治性切除术的ICC的独立预后指标。将AGR纳入现有的TNM分期系统中，提高了预测准确性。
The prognosis of intrahepatic cholangiocarcinoma (ICC) remains poor whereas predictive models for survival prediction in ICC patients following curative resection are limited. Herein, we established a novel inflammation-based score derived from preoperative albumin to gamma-glutamyltransferase ratio (AGR) and evaluated its prognostic significance in ICC patients underwent curative resection. Prognostic value of AGR was retrospectively studied in a cohort comprising 206 ICC patients following curative resection. The predictive performance of AGR was compared with other inflammation-based scores and serological tumor markers in terms of concordance index (C-index). Further, prognostic nomograms incorporating AGR into the tumor-node-metastasis (TNM) staging systems were established to achieve a better discriminatory ability. The optimal cut-off value of AGR was 0.6. Multivariate analysis showed that AGR was an independent predictor for overall survival (OS; P = 0.003) and recurrence-free survival (RFS; P = 0.046). The C-index of AGR was superior to other inflammation-based scores and serological tumor markers in OS and RFS prediction. The established nomograms showed improved predictive accuracy compared with the TNM staging systems alone. These results indicate that AGR is an independent prognostic indicator for ICC underwent curative resection. The incorporation of AGR into the existing TNM staging systems achieved improved predictive accuracy.