Clinical impact of pretreatment albumin–globulin ratio in patients with colorectal cancer

Abstract

Background: Accumulating evidence have revealed that pretreatment albumin to globulin ratio (AGR) may be a predictor of prognosis among patients with colorectal cancer (CRC). However, these findings are inconsistent. The aim of the present study was to investigate the prognostic value of pretreatment AGR in CRC. Methods: A systematic meta-analysis was conducted by searching MEDLINE, EMBASE, and Cochrane Library databases. Results: A total of 9 studies with 7939 patients were finally included. Low pretreatment AGR was associated with worse overall survival (pooled hazard ratio [HR]: 2.07, 95% CI: 1.60–2.67, P < .001) and disease-free survival/progress-free survival (pooled hazard ratio [HR]: 2.10, 95% confidence interval [CI]: 1.34–3.31, P = .001). Subgroup analyses revealed that the pooled correlation did not alter these results. Moreover, low pretreatment AGR were associated with elderly patients, tumor diameter (≥50 mm), tumor node metastasis stage (III–IV), depth of tumor (T3–4), and CA19-9 (>37 U/mL). Conclusion: The present meta-analysis suggests that low pretreatment AGR was associated with advanced clinicopathological features and worse prognosis, suggesting AGR is a useful prognostic biomarker for CRC patients.

C-reactive protein/albumin ratio of immune-inflammation index is associated with prognosis of colorectal cancer in older patients (≥ 65 years)

“…IL-1 and IL-6 are also released during cancer development; therefore, the value of CRP can re ect the in ammatory status around tumor microenvironments that contributes to tumor growth and cancer progression [14,16]. Albumin acts as an antioxidant against carcinogens by promoting cell growth and DNA stabilization [17]. Hypoalbuminemia results in worse recovery following pathologies and is associated with carcinogenesis and cancer cachexia [17][18][19].…”

“…Albumin acts as an antioxidant against carcinogens by promoting cell growth and DNA stabilization [17]. Hypoalbuminemia results in worse recovery following pathologies and is associated with carcinogenesis and cancer cachexia [17][18][19]. High levels of CAR is associated with poor prognosis in hepatocellular carcinoma, esophageal cancer, lung cancer, and CRC [20][21][22][23].…”

Serum albumin to globulin ratio prior to treatment as a potential non-invasive prognostic indicator for urological cancers

“…A meta-analysis conducted by Li et al ( 52 ) discovered that a decreased AGR suffer from worse OS and DFS in patients with lung cancer. In colorectal cancer, Ma et al ( 53 ) provided evidence that low pretreatment AGR was related to poor OS (HR = 2.07, P < 0.01) and DFS/PFS (HR = 2.10, P = 0.01), and advanced clinicopathological features, including age, tumor size, node metastasis stage, and tumor depth. Additionally, many recent studies have explored the association between the AGR and genitourinary cancers.…”

Prognostic value of pretreatment serum albumin−globulin ratio in urothelial carcinoma: A systematic review and meta-analysis

“…A meta-analysis conducted by Lv et al (40) discovered that decreased AGR resulted in worse OS and PFS, and increased cancer recurrence or progression in many malignancies. In colorectal cancer, Ma et al (51) provided evidence that low pretreatment AGR was related poor OS (HR=2.07, P < 0.01) and DFS/PFS (HR=2.10, P = 0.01), and advanced clinicopathological features, including age, tumor size, node metastasis stage, tumor depth. Additionally, many multicenter studies successively explored the correlation between the AGR and UC in recent years.…”