术前白蛋白与球蛋白比值作为泌尿系统癌症的重要预后指标：一项荟萃分析。

Preoperative albumin-to-globulin ratio as a significant prognostic indicator in urologic cancers: a meta-analysis.

作者信息

Zhang Yi, Wang Lijuan, Lin Shibu, Wang Rong

机构信息

Department of General Surgery, The First People's Hospital of Neijiang, Neijiang 641000, Sichuan Province, China,

Department of Nephrology, Shangrao People's Hospital, Shangrao 334000, Jiangxi Province, China.

出版信息

Cancer Manag Res. 2018 Oct 17;10:4695-4708. doi: 10.2147/CMAR.S178271. eCollection 2018.

BACKGROUND

Emerging studies reported that preoperative albumin-to-globulin ratio (AGR) correlated with tumor progression and prognosis in several types of cancer. The aim of this study was to systematically explore the association between preoperative AGR and clinical outcomes in cancers of the urinary system.

METHODS

Relevant articles were searched in PubMed, Embase and Web of Science by two independent investigators from inception to June 1, 2018. Eligible studies were selected based on predetermined selection criteria. Summarized HRs or ORs and 95% CIs were calculated for prognosis and clinicopathologic features with the fixed-effects or random-effects models.

RESULTS

Eight cohort studies comprising 2,668 patients were included for analysis. The pooled results showed that a low AGR significantly correlated with poor OS (HR: 0.38, 95% CI: 0.27-0.48, <0.001), worse cancer-specific survival (CSS) (HR: 0.36, 95% CI: 0.22-0.50, <0.001) and inferior event-free survival (EFS) (HR: 0.36, 95% CI: 0.25-0.48, <0.001) in urologic cancers. In addition, patients in low and high AGR groups showed significant differences in lymphovascular invasion (<0.001), pT status (<0.001) and pN status (<0.001).

CONCLUSION

Preoperative AGR might be a valuable, cheap and reproducible prognostic bio-marker in urologic cancers following surgical resection.

背景

新兴研究报道，术前白蛋白与球蛋白比值（AGR）与几种类型癌症的肿瘤进展及预后相关。本研究旨在系统探讨术前AGR与泌尿系统癌症临床结局之间的关联。

方法

两名独立研究人员在PubMed、Embase和Web of Science中检索自数据库建立至2018年6月1日的相关文章。根据预先设定的选择标准标准标准选择符合条件的研究。采用固定效应或随机效应模型计算预后及临床病理特征的汇总风险比（HR）或比值比（OR）以及95%置信区间（CI）。

结果

纳入八项队列研究，共2668例患者进行分析。汇总结果显示，低AGR与泌尿系统癌症患者较差的总生存期（HR：0.38，95%CI：0.27 - 0.48，<0.001）、更差的癌症特异性生存期（CSS）（HR：0.36，95%CI：0.22 - 0.50，<0.001）和较差的无事件生存期（EFS）（HR：0.36，95%CI：0.25 - 0.48，<0.001）显著相关。此外，低AGR组和高AGR组患者在淋巴管侵犯（<0.001）、pT分期（<0.001）和pN分期（<0.001）方面存在显著差异。