Prognostic Effect of Albumin-to-Globulin Ratio in Patients with solid tumors: A Systematic Review and Meta-analysis

Abstract

Background: Albumin and globulin are main components of serum protein. The level of albumin and globulin partially represents the nutrition status and immune system. Albumin-to-globulin ratio (AGR) has been reported as a prognostic factor in various cancers. We therefore performed a meta-analysis to elucidate the prognosis effect of AGR on survival outcomes in solid tumors.Method: Six electronic database were searched for the relevant articles that assessing the prognostic value of pre-treatment AGR in solid tumor patients. The primary outcome was overall survival (OS) and the secondary outcomes were cancer-specific survival (CSS), disease-free survival (DFS) and disease-metastasis-free survival (DMFS). The time-to-event outcomes were summarized in hazard ratio (HR) and 95% confidence interval (CI).Result: A total of 13890 solid tumor patients in 24 studies were included. The AGR higher than the cut-off values ranging from 1.15-1.75 was related to better OS (HR=0.58, 95%CI 0.537-0.626, p<0.0001), CSS (HR=0.287, 95%CI 0.187-0.438, p<0.0001), DFS (HR=0.792, 95%CI 0.715-0.878, p<0.0001) and DMFS (HR=0.595, 95%CI 0.447-0.792, p<0.0001). According to the cut-off values, subgroup analysis showed that AGR had significant prognostic effect on OS in each cut-off intervals (≤1.20, 1.20-1.40 and ≥1.40).Conclusion: Pre-treatment AGR is an effective prognostic factor and high AGR represents an ideal clinical outcome in the solid tumor patients.

High platelet-to-lymphocyte ratio is associated with poor prognosis in patients with unresectable intrahepatic cholangiocarcinoma receiving gemcitabine plus cisplatin

“…We chose to use dichotomized cut-offs because previous studies utilizing such cut-offs have shown a better association between PLR and overall survival than those with three risk categories [ 23 ]. The optimal cut-off values in the present study, which were determined using a statistical method, were similar to those of the previous studies [ 26 – 29 ]. Nevertheless, they warrant further validation in large, prospective studies since outcome-oriented approach to select cut-off value might result in overfitting.…”

“…Globulin plays an important role in immunity and inflammation. Because levels of both albumin and globulin are easily influenced by factors, such as dehydration or oedema, AGR has been suggested and explored as a prognostic factor in several cancers [ 26 ]. In the present study, the serum albumin levels and AGR were significantly associated with distant LN metastasis, which was the strongest independent predictive factor of PFS and OS.…”

Negative lymph node at station 108 is a strong predictor of overall survival in esophageal cancer

“…Based on the results of the present study, the AGR may be a more reliable predictor of outcomes inpatients, compared with the LNR. The reason for this may be that AGR may provide a true reflection of the condition of a patient that the AGR provides the combined information of immune and nutritional situation of patients (27,28). According to previous studies, AGR was considered to be closely associated with the patient immune system, and may be used as an indicator of the immune condition of patients in the future (29,30).…”

Kadar Protein Terlarut dalam Albumin Ikan Gabus (Channa striata dan Channa micropeltes) Asal Bogor SOLUBLE ROTEIN CONCENTRATION IN SNAKEHEAD FISH ALBUMIN BOGOR ORIGIN (CHANNA STRIATA AND CHANNA MICROPELTES)

“…Ikan gabus dimanfaatkan dalam bidang kesehatan yang disebut sebagai medicinal freshwater fish, seperti digunakan untuk mempercepat proses penyembuhan luka pascaoperasi dan melahirkan (Rahayu et al, 2016). Ikan gabus memiliki manfaat biomedik yan g san gat mengu ntung kan, seperti antiradang, antijasad renik, antinyeri nosisepsi (nociception) dan sifat antikanker (Hue et al, 2017). Ikan gabus mengandung asam amino dan asam lemak dengan kadar yang tinggi dan memiliki kemampuan bagus dalam proses penyembuhan luka (Shafri dan Abdul, 2012).…”

“…Firlianty et al (2014) menyatakan bahwa asam amino yang dikandung dalam daging ikan gabus di antaranya asam amino arginin (3,55%), valin (7,58%), isoleusin (5,36%), asam aspartat (16,09%), tirosin (1,99%), alanin (15,62%), dan tirosin (2,68%). Albumin yang dikandung dalam daging ikan gabus berperan penting dalam peredaran dan farmakodinamik obat antikanker (Hue et al, 2017). Albumin ikan gabus sangat baik digunakan untuk penderita hipoalbumin (rendah albumin), dan penyembuhan luka pascaoperasi dan luka bakar (Evi dan Ika, 2013).…”