Albumin to globulin ratio, a predictor or a misleader?

Alkan, Ali; Köksoy, Elif Berna; Utkan, Güngör

doi:10.1093/annonc/mdu554

Cited by 18 publications

(16 citation statements)

References 1 publication

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“…Moreover, the cutoff values of the AGR, FAR, and FPR were inconsistent with those in previous studies, which may have been caused by the small sample size or the different types of tumors. Third, the AGR, FAR, PGR, and FPR were not independent predictors for PFS in the multivariate analysis, suggesting that these four predictors are susceptible to multiple factors . However, as mentioned above, the AGR, FAR, PGR, and FPR reflect two states of inflammation and nutrition compared with albumin, globulin, fibrinogen, and prealbumin alone, making them more powerful prognostic predictors.…”

Section: Discussionmentioning

confidence: 87%

“…Tumor cells in cancer patients are characterized by rapid cell proliferation, which accelerates cell metabolism, consumes albumin, and severely reduces its storage capacity. Patients with gastrointestinal tumors are at a higher risk of hypoproteinemia than other cancer patients due to possible gastrointestinal obstruction and malabsorption . As a sensitive marker, the nutritional status of cancer patients can be evaluated by albumin.…”

Section: Discussionmentioning

confidence: 99%

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Potential prognostic factors for predicting the chemotherapeutic outcomes and prognosis of patients with metastatic colorectal cancer

Zhang

Wang

et al. 2019

Clinical Laboratory Analysis

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ObjectivesThe purpose of this study was to explore whether pretreatment potential prognostic factors are related to chemotherapeutic outcomes and the prognosis of inpatients with metastatic colorectal cancer (mCRC) undergoing chemotherapy.Materials and methodsData from 71 patients with mCRC were analyzed retrospectively. The relationship between the potential prognostic factors before first‐line chemotherapy and the clinicopathological characteristics and chemotherapy response of the patients was calculated using Fisher's exact test and the chi‐square test. The prognostic factors were analyzed using univariate and multivariate analyses. We analyzed the subgroups using the Mann‐Whitney U test.ResultsFour factors were eventually used as prognostic factors, namely the albumin‐to‐globulin ratio (AGR), the fibrinogen‐to‐albumin ratio (FAR), the prealbumin‐to‐globulin ratio (PGR), and the fibrinogen‐to‐prealbumin ratio (FPR); the cutoff values of the four potential prognostic factors were 1.40, 10.63, 5.44, and 18.49, respectively. The high AGR and PGR groups had a higher response rate than that of the low groups. Patients in the low FAR and FPR groups showed a higher objective response rate than the high FAR and FPR groups. Patients with low FPR were associated with a higher disease control rate than patients with high FPR. Higher progression‐free survival (PFS) was observed in the high AGR and PGR and low FAR and FPR groups. The AGR, FAR, PGR, and FPR were considered reliable prognostic factors for PFS in a univariate analysis.ConclusionsThe prechemotherapy AGR, FAR, PGR, and FPR were good prognostic factors to predict the chemotherapy response and PFS in patients with mCRC.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Potential prognostic factors for predicting the chemotherapeutic outcomes and prognosis of patients with metastatic colorectal cancer

Zhang

Wang

et al. 2019

Clinical Laboratory Analysis

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“…[20] First, patients with gastrointestinal cancer often suffer from poor absorption, which results in hypoalbuminemia. [21] Second, the tumor can cause chronic inflammation which will produce some cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor. These cytokines promote the inhibition of ALB synthesis and the enhancement of capillary permeability, which will induce the loss of ALB.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of preoperative albumin to globulin ratio in elderly patients with rectal cancer

Cheng

et al. 2019

Medicine

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To identify the value of predictors of poor prognosis of elderly patients with rectal cancer who underwent surgery, we investigated the relations between albumin to globulin ratio (AGR) and clinicopathological findings. We conducted a retrospective cohort study of clinicopathological characteristics (general status, pathological features of tumors, preoperative laboratory data, disease free, and overall survival) for elderly patients with stage I-III rectal cancer. The AGR is calculated as albumin/(total protein − albumin). According to the optimal cut-off point of AGR (1.43), the enrolled patients were divided into low AGR (n = 83) and high AGR (n = 136) groups. Meanwhile, age, hemoglobin, tumor size, and differentiation degree were the independent risk factors of low preoperative AGR value. Compared to patients with high AGR, those with low AGR were related to worse disease-free survival (DFS) ( P = .0008) and overall survival (OS) ( P = .0003). Moreover, in multivariate analysis, low AGR and poor TNM stage were the independent predictor of poor DFS and OS. Finally, the nomograms illustrated the effect of prognostic factors on DFS and OS. Preoperative AGR has a significant prognostic value and was identified as an independent predictor of DFS and OS in elderly rectal cancer patients.

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“…There exists close interactions between serum albumin and tumors, with the results that the serum albumin level provides potential prognostic significance in cancer (5). Firstly, because of anepithymia and malabsorption, patients with gastrointestinal cancers have a higher risk of hypoalbuminemia compared to others (16). Secondly, the tumor can induce systemic inflammation, which in turn, may be a stimulus for tumor and immune cells to produce cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor.…”

Section: Discussionmentioning

confidence: 99%

“…The level of serum albumin and globulin measured at the same time may reflect different periods of status (24). In addition, Alkan (16) recognized that AGR was not a predictor but a misleader because AGR can be affected by multiple factors. It is similar to our finding that the level of preoperative AGR can be significantly influenced by gender, age, preoperative hemoglobin, and tumor size.…”

Section: Discussionmentioning

confidence: 99%

Preoperative albumin/globulin ratio is a potential prognosis predicting biomarker in patients with resectable gastric cancer

Xue

Lin²,

Yin³

et al. 2017

Turk J Gastroenterol

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Albumin to globulin ratio, a predictor or a misleader?

Cited by 18 publications

References 1 publication

Potential prognostic factors for predicting the chemotherapeutic outcomes and prognosis of patients with metastatic colorectal cancer

Potential prognostic factors for predicting the chemotherapeutic outcomes and prognosis of patients with metastatic colorectal cancer

Prognostic value of preoperative albumin to globulin ratio in elderly patients with rectal cancer

Preoperative albumin/globulin ratio is a potential prognosis predicting biomarker in patients with resectable gastric cancer

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