Prognostic Value of Albumin/Globulin Ratio in Survival and Lymph Node Metastasis in Patients with Cancer: A Systematic Review and Meta-analysis

Chi, Jieshan; Xie, Qizhi; Jia, Jingjing; Liu, Xiaoma; Sun, Jingjing; Chen, Junhui; Li, Yang

doi:10.7150/jca.24889

Cited by 40 publications

(25 citation statements)

References 43 publications

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“…The AGR, which accounts for the values of both albumin and globulin, can be used as one of the inflammatory parameters to evaluate the systemic inflammatory status of the host ( 14 ). In addition to reflecting the nutritional status of the host, serum albumin can also be affected by inflammatory factors, which in turn reflects the level of inflammation in the body ( 15 ). Albumin production can be regulated by proinflammatory cytokines such as tumor necrosis factor (TNF) and interleukin-6 (IL-6).…”

Section: Discussionmentioning

confidence: 99%

A Low Albumin-to-Globulin Ratio Predicts a Poor Prognosis in Patients With Metastatic Non-small-cell Lung Cancer

Lü

Wei

et al. 2021

Front. Med.

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Objective: The serum albumin-to-globulin ratio (AGR) may be a useful prognostic factor for various cancers. This study aimed to evaluate the prognostic value of the AGR in patients with metastatic non-small-cell lung cancer (NSCLC).Methods: A retrospective study was conducted on patients with stage IV NSCLC diagnosed in Hubei Cancer Hospital from July 2012 to December 2013. The formula for calculating the AGR was serum albumin/total protein-serum albumin. The chi-square test or Fisher's exact test was used to analyze the classified variables. The Kaplan-Meier method was used to analyze the overall survival (OS) rate, which was plotted with the R language. The impact of the AGR on OS and progression-free survival (PFS) was analyzed by a multivariate Cox proportional hazard model.Results: A total of 308 patients were included in the study population. The optimal cutoff values for the AGR in terms of OS and PFS were 1.12 and 1.09, respectively, as determined by X-Tile software. Kaplan-Meier curve analysis showed that the difference in survival rate between patients with different AGR levels was statistically significant (p = 0.04). The OS of patients with a high AGR (≥1.12) was longer than that of patients with a low AGR (<1.12). PFS in the high AGR group were better than those in the low AGR group (16.90 vs. 32.07months, p = 0.008). The univariate and multivariate models proved that the AGR was an independent prognostic factor in metastatic NSCLC patients in terms of both OS (p = 0.009, hazard ratio [HR] = 0.55, 95% confidence interval [95% CI] = 0.35–0.86) and PFS (p = 0.004, HR = 0.55, 95% CI = 0.37–0.83).Conclusion: The AGR, which is measured in routine clinical practice, is an independent prognostic factor in terms of OS and PFS in metastatic NSCLC and can serve as a prognostic tool for metastatic NSCLC.

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Section: Discussionmentioning

confidence: 99%

A Low Albumin-to-Globulin Ratio Predicts a Poor Prognosis in Patients With Metastatic Non-small-cell Lung Cancer

Lü

Wei

et al. 2021

Front. Med.

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“…Platelet counts between patients with and without BPT were almost equal; thus, PLR and SII, which combine PLR and neutrophil count, did not have a high predictive value. The AGR reflects the nutritional and inflammatory state by combining albumin and globulin, which are the major components of human total serum proteins . In terms of malnutrition, PNI was more predictive than AGR, perhaps because PNI uses two independent factors, albumin and lymphocyte count, whereas AGR uses two related factors.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the predictive value among inflammation‐based scoring systems for bleomycin pulmonary toxicity in patients with germ cell tumors

et al. 2019

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Abbreviations & Acronyms AGR = albumin-to-globulin ratio AUC = area under the curve BEP = bleomycin, etoposide and cisplatin BMI = body mass index BPT = bleomycin pulmonary toxicity CI = confidence interval CRP = C-reactive protein DLCO = diffusing capacity of the lung for carbon monoxide eGFR = estimated glomerular filtration rate FN = febrile neutropenia G-CSF = granulocyte colonystimulating factor GCT = germ cell tumors GPS = Glasgow Prognostic Score IGCCC = International Germ Cell Consensus Classification NLR = neutrophil-to-lymphocyte ratio PFT = pulmonary function test PLR = platelet-to-lymphocyte ratio PNI = Prognostic Nutritional Index ROC = receiver operating characteristic ROS = reactive oxygen species SII = systemic immuneinflammation index VIP = etoposide, ifosfamide and cisplatin WBC = white blood cell Objective: To compare the predictive value of pretreatment inflammation-based scoring systems in patients with germ cell tumors receiving first-line bleomycin-based chemotherapy.Methods: Retrospectively, we evaluated 57 patients with germ cell tumors. Bleomycin pulmonary toxicity was defined as the presence of asymptomatic decline in pulmonary function tests, pulmonary symptoms or interstitial pneumonia on computed tomography in the absence of infection. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, albumin-to-globulin ratio, Prognostic Nutritional Index, Glasgow Prognostic Score and C-reactive protein were measured in all patients. To assess the predictive ability of each scoring system, the area under the receiver operating characteristic curve was calculated, and multivariate analysis was carried out to identify the predictive scores associated with bleomycin pulmonary toxicity. Results: Of the 57 patients, 15 patients developed bleomycin pulmonary toxicity. The neutrophil-to-lymphocyte ratio had the highest area under the curve value (0.763) of all inflammation-based scoring systems, followed by the Prognostic Nutritional Index (0.749). In multivariate analysis, the neutrophil-to-lymphocyte ratio (odds ratio 11.5; P = 0.009) and Prognostic Nutritional Index (odds ratio 9.07; P = 0.013) were independently associated with development of bleomycin pulmonary toxicity. As these two independent markers were combined, the area under the curve achieved the highest value (0.822).Conclusions: The present study shows that the neutrophil-to-lymphocyte ratio and Prognostic Nutritional Index are independent risk factors for development of bleomycin pulmonary toxicity. The combination of the neutrophil-to-lymphocyte ratio and Prognostic Nutritional Index seems to have superior predictive value compared with other inflammation-based scoring systems.

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“…Appropriate ratios of the studied bio-indicators could be prognostic [53].In the serum and liver homogenate of the rats, the total protein : albumin ratio was lower while the albumin : total protein ratio was higher, respectively in the rats exposed to MSG, Overdose of AL + MSG or overdose of AL when compared with the control. The observation could be a pointer to hitherto unknown underlying pathology as recently low albumin/globulin ratio was significantly associated with poor overall survival in various cancers [54] while a low albumin to globulin ratio was a prognostic marker for poor survival in cervical cancer patients [55]. Generally, the non-significant (P>0.05) and inconsistent responses in some groups, is not surprising.…”

Section: Discussionmentioning

confidence: 85%

Monosodium Glutamate Plus Artemether-lumefantrine Overdose Altered Malondialdehyde, Total Protein and Albumin Concentration in Rats

et al. 2019

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This study aimed at assessing alterations in malondialdehyde, MDA, total protein and albumin concentration in the serum and liver homogenate of monosodium glutamate (MSG)-challenged rats co-treated with artemether-lumefantrine, AL. Methods involving colourimetric estimation were employed in thirty rats randomly grouped into six (n = 5) and for seven consecutive days, fed feed and water (Group A), AL therapeutic dose (Group B), AL overdose (therapeutic dose × 5) (Group C), MSG (8000 mg/kg body weight) (Group D), AL therapeutic dose plus MSG (Group E) or AL overdose plus MSG (Group F). Total protein concentration (2.64±0.09 g/dL, 2.81±0.14g/dL, respectively) in the liver homogenate of rats exposed to MSG (group D) or MSG plus AL overdose (group F) and malondialdehyde concentration in the liver homogenate of MSG plus AL overdose-fed rats (0.45±0.04 mg/ml) lowered (P<0.05) as against other groups. However, serum albumin concentration in MSG (2.59±0.13 g/dl) or AL overdose plus MSG (3.24±0.12 g/dl) fed rats was higher (P<0.05) compared to the control (2.02±0.04 g/dl). The Total protein: Albumin ratio lowered while the Albumin: total protein ratio increased in rats in MSG, AL overdose plus MSG or AL overdose groups compared with the control. Thus, the apparent MSG plus AL overdose-induced adverse influence on the studied parameters and samples of non-malarial infested rats could be via compromised liver-mediated protein metabolism capacity and bio-functions following possibly enhanced protein-malondialdehyde adduct formation in the rats.

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Prognostic Value of Albumin/Globulin Ratio in Survival and Lymph Node Metastasis in Patients with Cancer: A Systematic Review and Meta-analysis

Cited by 40 publications

References 43 publications

A Low Albumin-to-Globulin Ratio Predicts a Poor Prognosis in Patients With Metastatic Non-small-cell Lung Cancer

A Low Albumin-to-Globulin Ratio Predicts a Poor Prognosis in Patients With Metastatic Non-small-cell Lung Cancer

Comparison of the predictive value among inflammation‐based scoring systems for bleomycin pulmonary toxicity in patients with germ cell tumors

Monosodium Glutamate Plus Artemether-lumefantrine Overdose Altered Malondialdehyde, Total Protein and Albumin Concentration in Rats

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