A low preoperative albumin-to-globulin ratio is a negative prognostic factor in patients with surgically treated cervical cancer
A low preoperative albumin-to-globulin ratio is a negative prognostic factor in patients with surgically treated cervical cancer
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DOI：
10.1007/s10147-021-01861-8
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发表时间：
2021-01-21
影响因子：
3.3
通讯作者：
Fujii, Tomoyuki
中科院分区：
文献类型：
--
作者：
Kawata, Akira;Taguchi, Ayumi;Fujii, Tomoyuki
背景：白蛋白/球蛋白比值反映了各种恶性肿瘤患者的营养状况和炎症状态，并可预测患者的预后。然而，在接受手术的宫颈癌患者中，其意义尚未确定。方法选择2005-2017年间在我所接受手术治疗的宫颈癌患者247例。对术前血清白蛋白、球蛋白、白蛋白/球蛋白比值等临床病理指标进行回顾性分析，并分析其与总生存期的关系。结果中位随访时间为58.6个月，共观察到49例复发，26例死亡。低白蛋白/球蛋白比值(<；1.345)、低白蛋白(<；3.25g/dL)和高球蛋白水平(>；=3.25g/dL)与预后不良显著相关。多因素分析显示，低白蛋白/球蛋白比值是影响总生存期的独立预后因素(HR=2.59，95%CI1.12~5.96，P=0.026)，而低白蛋白或高球蛋白水平与总生存期无关。在临床病理特征中，高龄、糖尿病、高血压、较大的肿瘤大小和宫旁侵犯与低白蛋白/球蛋白比率有关。结论低白蛋白/球蛋白比值与手术治疗的浸润性宫颈癌患者预后不良有关。因此，白蛋白/球蛋白比值可作为预后指标，预示预后较差。
Background The albumin-to-globulin ratio reflects both the nutrition and inflammation and predicts prognosis in patients with various malignancies. However, in cervical cancer patients who undergo surgery, its significance has yet to be established. Methods A total of 247 cervical cancer patients who received surgical treatment at our institution between 2005 and 2017 were enrolled in this study. Preoperative data, such as the levels of serum albumin and serum globulin as well as the albumin-to-globulin ratio along with the other clinicopathological characteristics were retrospectively assessed, and their association with the overall survival was analyzed. Results Overall, 49 cases of recurrence and 26 deaths were observed during the median follow-up time of 58.6 months. A low albumin-to-globulin ratio (< 1.345) as well as low albumin (< 3.25 g/dL) and high globulin levels (>= 3.25 g/dL) were significantly associated with poor prognosis. According to the multivariate analysis, a low albumin-to-globulin ratio was an independent prognostic factor for overall survival (HR = 2.59, 95% CI 1.12-5.96, P = 0.026); however, low albumin or high globulin levels was not associated with the overall survival. Among the clinicopathological characteristics, older age, diabetes mellitus, hypertension, larger tumor size, and parametrial invasion were associated with a low albumin-to-globulin ratio. Conclusion A low albumin-to-globulin ratio was associated with a poor prognosis in patients with surgically treated invasive cervical cancer. Therefore, the albumin-to-globulin ratio may serve as a prognostic marker, which predicts a worse prognosis.