Wang Ning, Liu Jian-Ye, Li Xiong, Deng Min-Hua, Long Zhi, Tang Jin, Yao Kun, Zhang Yi-Chuan, He Le-Ye
Department of Urology, The Third Xiangya Hospital of Central South University, Changsha 410013, China Institute of Prostate Disease of Central South University, Changsha 410013, China Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha 410008, China Hunan Key Laboratory of Molecular Radiation Oncology, Xiangya Hospital, Central South University, Changsha 410008, China.
Asian J Androl. 2019 Jan 1;21(1):56-61. doi: 10.4103/aja.aja_50_18.
The pretreatment serum albumin/globulin ratio (AGR) has been used as a prognostic biomarker for various cancer types. However, the prognostic value of the AGR for prostate cancer, especially for metastatic prostate cancer (mPCa) after maximal androgen blockade (MAB), remains unclear. The aim of this study was to evaluate the prognostic value of the pretreatment serum AGR for mPCa treated with MAB. This retrospective study included 214 mPCa patients receiving MAB from October 2007 to March 2017. The correlation of the AGR with survival was estimated using Kaplan-Meier analysis and Cox proportional hazards models. The cutoff value of the AGR was 1.45 according to the receiver operating characteristic curve. Kaplan-Meier analysis demonstrated that patients with a low AGR (<1.45) had poor outcomes in terms of progression-free survival (PFS) and cancer-specific survival (CSS). Multivariate Cox analyses showed that the AGR was an independent predictor of PFS (hazard ratio [HR] = 0.642; 95% confidence interval [CI]: 0.430-0.957; P = 0.030) and CSS (HR = 0.412; 95% CI: 0.259-0.654; P < 0.001). Furthermore, in a subset of 79 patients with normal serum albumin levels (≥40.0 g l -1 ), the serum AGR remained an independent predictor of CSS ( P = 0.009). The pretreatment AGR was an independent prognostic biomarker for PFS and CSS in patients with mPCa receiving MAB. In addition, the AGR remained effective for the prediction of CSS in patients with normal albumin levels (≥40 g l -1 ). However, further prospective studies are needed to confirm our conclusions.
预处理血清白蛋白/球蛋白比值（AGR）已被用作多种癌症类型的预后生物标志物。然而，AGR对前列腺癌，尤其是最大雄激素阻断（MAB）后的转移性前列腺癌（mPCa）的预后价值仍不清楚。本研究的目的是评估预处理血清AGR对接受MAB治疗的mPCa的预后价值。这项回顾性研究纳入了2007年10月至2017年3月期间接受MAB治疗的214例mPCa患者。使用Kaplan-Meier分析和Cox比例风险模型评估AGR与生存的相关性。根据受试者工作特征曲线，AGR的临界值为1.45。Kaplan-Meier分析表明，AGR低（<1.45）的患者在无进展生存期（PFS）和癌症特异性生存期（CSS）方面预后较差。多变量Cox分析显示，AGR是PFS（风险比[HR]=0.642；95%置信区间[CI]：0.430-0.957；P=0.030）和CSS（HR=0.412；95%CI：0.259-0.654；P<0.001）的独立预测因子。此外，在79例血清白蛋白水平正常（≥40.0 g l-1）的患者亚组中，血清AGR仍然是CSS的独立预测因子（P=0.009）。预处理AGR是接受MAB治疗的mPCa患者PFS和CSS的独立预后生物标志物。此外，AGR对白蛋白水平正常（≥40 g l-1）的患者的CSS预测仍然有效。然而，需要进一步的前瞻性研究来证实我们的结论。
