Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Estambul, Turquía.
Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Estambul, Turquía.
Actas Urol Esp (Engl Ed). 2020 Sep;44(7):469-476. doi: 10.1016/j.acuro.2020.03.011. Epub 2020 Jun 26.
In recent years, the incidence of testicular cancer has increased, but mortality rates have decreased thanks to the improvements in treatment. Although primary tumor characteristics and serum tumor markers are associated with metastasis and relapse, their predictive value is not reliable. Therefore, there is a need for new biomarkers that predict prognosis. In this study, we aimed to investigate the role of preoperative albumin to globulin ratio (AGR) in predicting retroperitoneal lymph node (RPLN) involvement, distant metastasis and prognosis in testicular cancer.
We retrospectively analyzed the medical records of all patients that underwent radical inguinal orchiectomy at our hospital between 2007 and 2018. AGR was calculated using the equation: AGR=serum albumin/(serum total protein-serum albumin). The predictive value of AGR for RPLN involvement and distant metastasis was evaluated using receiver operating characteristic analysis and its prognostic value was evaluated using Kaplan-Meier survival analysis.
A total of 115 patients with a mean age of 33.4±7.7years were included in the study. In multivariate analysis, AGR less than 1.47 and the presence of lymphovascular invasion were detected as the factors predicting RPLN involvement and distant metastasis. The AGR of patients who had died was significantly lower than AGR of those who were alive, 1±0.2 versus 1.6±0.3 (P=.001). In Kaplan-Meier survival analysis, the mean survival of patients with higher AGR (>1.47) was found longer than patients with lower AGR (<1.47).
Preoperative AGR is a biomarker that may be used in predicting RPLN involvement, distant metastasis and prognosis in testicular cancer.
近年来，尽管由于治疗方法的改进，睾丸癌的发病率有所增加，但死亡率却有所下降。尽管原发肿瘤特征和血清肿瘤标志物与转移和复发有关，但它们的预测价值并不可靠。因此，需要新的生物标志物来预测预后。本研究旨在探讨术前白蛋白/球蛋白比值（AGR）在预测睾丸癌腹膜后淋巴结（RPLN）受累、远处转移和预后中的作用。
我们回顾性分析了 2007 年至 2018 年间在我院行根治性腹股沟睾丸切除术的所有患者的病历。AGR 通过方程计算：AGR=血清白蛋白/（血清总蛋白-血清白蛋白）。使用受试者工作特征分析评估 AGR 对 RPLN 受累和远处转移的预测价值，使用 Kaplan-Meier 生存分析评估其预后价值。
共纳入 115 例平均年龄为 33.4±7.7 岁的患者。多因素分析显示，AGR<1.47 和存在血管淋巴管侵犯是预测 RPLN 受累和远处转移的因素。死亡患者的 AGR 明显低于存活患者，分别为 1±0.2 与 1.6±0.3（P=.001）。Kaplan-Meier 生存分析显示，AGR 较高（>1.47）患者的平均生存时间长于 AGR 较低（<1.47）患者。
术前 AGR 是一种生物标志物，可用于预测睾丸癌的 RPLN 受累、远处转移和预后。
