Otsuka Masafumi, Kamasako Tomohiko, Uemura Toshihiro, Takeshita Nobushige, Shinozaki Tetsuo, Kobayashi Masayuki, Komaru Atsushi, Fukasawa Satoshi
Prostate Center and Division of Urology, Chiba Cancer Center, Chiba, Japan.
Int J Urol. 2018 Oct;25(10):871-878. doi: 10.1111/iju.13767. Epub 2018 Aug 13.
To elucidate the effects of the preoperative albumin : globulin ratio on the survival of patients with upper tract urothelial carcinoma after radical nephroureterectomy.
We retrospectively reviewed 124 consecutive patients with upper tract urothelial carcinoma who underwent radical nephroureterectomy at Chiba Cancer Center, Chiba, Japan between 2002 and 2015. The albumin : globulin ratio was defined: albumin / (total protein - albumin). Associations between preoperative clinicopathological factors, including the albumin : globulin ratio, and recurrence-free survival, cancer-specific survival and overall survival were assessed. The log-rank test and Cox proportional hazards models were used for univariate and multivariable analyses, respectively. The study cohort was separated into two groups based on the optimal albumin : globulin ratio cut-off value determined using receiver operating characteristic curve analysis.
The median survival time was 55 months (interquartile range 28-76 months), and 31 patients died during follow up. A low preoperative albumin : globulin ratio <1.40 was associated with tumor grade and surgical margin status. Kaplan-Meier analyses showed that a low albumin : globulin ratio was more significantly correlated with worse recurrence-free survival, cancer-specific survival and overall survival. Multivariate analyses showed that a low albumin : globulin ratio was an independent predictive factor associated with poor recurrence-free survival (hazard ratio 3.758; P = 0.0028), cancer-specific survival (hazard ratio 5.687; P = 0.0044) and overall survival (hazard ratio 3.124; P = 0.0030).
A low albumin : globulin ratio is an independent predictive factor associated with poor prognosis in upper tract urothelial carcinoma patients treated with radical nephroureterectomy.
阐明术前白蛋白与球蛋白比值对根治性肾输尿管切除术后上尿路尿路上皮癌患者生存情况的影响。
我们回顾性分析了2002年至2015年间在日本千叶癌症中心接受根治性肾输尿管切除术的124例连续性上尿路尿路上皮癌患者。白蛋白与球蛋白比值定义为：白蛋白/（总蛋白 - 白蛋白）。评估术前临床病理因素（包括白蛋白与球蛋白比值）与无复发生存率、癌症特异性生存率和总生存率之间的关联。分别采用对数秩检验和Cox比例风险模型进行单变量和多变量分析。根据使用受试者工作特征曲线分析确定的最佳白蛋白与球蛋白比值临界值，将研究队列分为两组。
中位生存时间为55个月（四分位间距28 - 76个月），31例患者在随访期间死亡。术前白蛋白与球蛋白比值<1.40与肿瘤分级和手术切缘状态相关。Kaplan-Meier分析显示，低白蛋白与球蛋白比值与较差的无复发生存率、癌症特异性生存率和总生存率更显著相关。多变量分析显示，低白蛋白与球蛋白比值是与无复发生存率差（风险比3.758；P = 0.0028）、癌症特异性生存率差（风险比5.687；P = 0.0044）和总生存率差（风险比3.124；P = 0.0030）相关的独立预测因素。
低白蛋白与球蛋白比值是根治性肾输尿管切除术后上尿路尿路上皮癌患者预后不良的独立预测因素。
