Clinical burden of preoperative albumin-globulin ratio in esophageal cancer patients

Am J Surg. 2017 Nov;214(5):891-898. doi: 10.1016/j.amjsurg.2017.04.007. Epub 2017 Apr 25.

Abstract

Background: Lower albumin-globulin ratio (AGR) is associated with increased mortality in several cancers. However, no studies have evaluated the relationship between the AGR and prognostic outcome in esophageal cancer (EC) patients.

Methods: To identify indicators of early recurrence and poor prognosis, we assessed the clinicopathological findings and preoperative laboratory data (carcinoembryonic antigen [CEA], squamous cell carcinoma antigen, total protein, and albumin) of 112 EC patients who underwent surgery. The AGR was calculated as albumin/(total protein-albumin).

Results: A lower AGR was significantly associated with tumor progression. The CEA level was an independent predictor for overall survival (OS) and disease-free survival (DFS). The AGR and CEA combination was identified as a feasible indicator of poor prognosis and early recurrence. Among EC patients without lymph node metastasis, those with lower AGR had poorer DFS and OS than those with higher AGR.

Conclusion: AGR was identified as a significant predictor of OS and DFS in EC patients. Among EC patients without lymph node metastasis, AGR may help identify candidates who might benefit from more intensive adjuvant therapy.

Keywords: Albumin to globulin ratio; Esophageal cancer; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Esophageal Neoplasms / blood*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Female
  • Globulins / analysis*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Preoperative Period
  • Prognosis
  • Serum Albumin / analysis*
  • Survival Rate

Substances

  • Globulins
  • Serum Albumin