Kawata Akira, Taguchi Ayumi, Baba Satoshi, Miyamoto Yuichiro, Tanikawa Michihiro, Sone Kenbun, Tsuruga Tetsushi, Mori Mayuyo, Oda Katsutoshi, Kawana Kei, Osuga Yutaka, Fujii Tomoyuki
Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Division of Integrative Genomics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Int J Clin Oncol. 2021 May;26(5):980-985. doi: 10.1007/s10147-021-01861-8. Epub 2021 Jan 21.
The albumin-to-globulin ratio reflects both the nutrition and inflammation and predicts prognosis in patients with various malignancies. However, in cervical cancer patients who undergo surgery, its significance has yet to be established.
A total of 247 cervical cancer patients who received surgical treatment at our institution between 2005 and 2017 were enrolled in this study. Preoperative data, such as the levels of serum albumin and serum globulin as well as the albumin-to-globulin ratio along with the other clinicopathological characteristics were retrospectively assessed, and their association with the overall survival was analyzed.
Overall, 49 cases of recurrence and 26 deaths were observed during the median follow-up time of 58.6 months. A low albumin-to-globulin ratio (< 1.345) as well as low albumin (< 3.25 g/dL) and high globulin levels (≥ 3.25 g/dL) were significantly associated with poor prognosis. According to the multivariate analysis, a low albumin-to-globulin ratio was an independent prognostic factor for overall survival (HR = 2.59, 95% CI 1.12-5.96, P = 0.026); however, low albumin or high globulin levels was not associated with the overall survival. Among the clinicopathological characteristics, older age, diabetes mellitus, hypertension, larger tumor size, and parametrial invasion were associated with a low albumin-to-globulin ratio.
A low albumin-to-globulin ratio was associated with a poor prognosis in patients with surgically treated invasive cervical cancer. Therefore, the albumin-to-globulin ratio may serve as a prognostic marker, which predicts a worse prognosis.
白蛋白与球蛋白比值反映营养状况和炎症反应，并可预测多种恶性肿瘤患者的预后。然而，在接受手术治疗的宫颈癌患者中，其意义尚未明确。
本研究纳入了2005年至2017年间在我院接受手术治疗的247例宫颈癌患者。回顾性评估术前数据，包括血清白蛋白和球蛋白水平、白蛋白与球蛋白比值以及其他临床病理特征，并分析它们与总生存期的关系。
总体而言，在中位随访时间58.6个月期间，观察到49例复发和26例死亡。低白蛋白与球蛋白比值（<1.345）以及低白蛋白（<3.25 g/dL）和高球蛋白水平（≥3.25 g/dL）与预后不良显著相关。多因素分析显示，低白蛋白与球蛋白比值是总生存期的独立预后因素（HR=2.59，95%CI 1.12-5.96，P=0.026）；然而，低白蛋白或高球蛋白水平与总生存期无关。在临床病理特征中，年龄较大、糖尿病、高血压、肿瘤体积较大和宫旁浸润与低白蛋白与球蛋白比值相关。
低白蛋白与球蛋白比值与手术治疗的浸润性宫颈癌患者预后不良相关。因此，白蛋白与球蛋白比值可作为一种预后标志物，提示预后较差。
