Aktepe Oktay Halit, Güner Gürkan, Güven Deniz Can, Taban Hakan, Yıldırım Hasan Çağrı, Şahin Taha Koray, Ardıç Fadime Sinem, Yeter Hacı Hasan, Yüce Deniz, Erman Mustafa
Hacettepe University Cancer Institute, Ankara, Turkey.
Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk J Urol. 2021 Mar;47(2):113-119. doi: 10.5152/tud.2021.20377. Epub 2021 Mar 1.
The albumin to globulin ratio (AGR) has been demonstrated to be associated with survival outcomes in various tumor types. However, the prognostic value of AGR in patients with metastatic renal carcinoma (mRCC) remains unclear. Therefore, this study aimed to investigate the impact of AGR values in predicting overall survival (OS) of patients with mRCC treated with targeted therapy.
A total of 163 patients with mRCC treated with targeted therapy between 2008 and 2019 were enrolled. The AGR value was measured as AGR: albumin/(total protein-albumin). The Kaplan-Meier method with long-rank testing and Cox proportional hazard models were used to estimate the correlation of AGR with OS.
The receiver operating characteristic curve analysis showed that the optimal cut-off value of AGR in predicting OS was 1.11 with a sensitivity of 37.25% and specificity of 85.25% (area under curve, 0.62; 95% confidence interval [CI], 0.54-0.69; p=0.005). OS was significantly higher in patients with AGR>1.11 than in those with AGR≤1.11 (36.2 vs. 12.4 months; p<0.001). After adjustment for the number of covariates, multivariate Cox regression analysis identified a high AGR as an independent indicator of better OS (hazard ratio, 0.476; 95% CI, 0.304-0.745; p=0.001).
Our results suggested that AGR value, which is an easily obtainable and cost-effective marker in routine biochemistry testing, could function as an independent predictor of OS in patients with mRCC treated with targeted therapy.
白蛋白与球蛋白比值（AGR）已被证明与多种肿瘤类型的生存结果相关。然而，AGR在转移性肾癌（mRCC）患者中的预后价值仍不清楚。因此，本研究旨在探讨AGR值对接受靶向治疗的mRCC患者总生存期（OS）的预测影响。
纳入2008年至2019年间共163例接受靶向治疗的mRCC患者。AGR值的计算方法为AGR：白蛋白/（总蛋白-白蛋白）。采用Kaplan-Meier法及长秩检验和Cox比例风险模型来评估AGR与OS的相关性。
受试者工作特征曲线分析显示，AGR预测OS的最佳临界值为1.11，敏感性为37.25%，特异性为85.25%（曲线下面积为0.62；95%置信区间[CI]，0.54 - 0.69；p = 0.005）。AGR>1.11的患者的OS显著高于AGR≤1.11的患者（36.2个月对12.4个月；p<0.001）。在对协变量数量进行调整后，多因素Cox回归分析确定高AGR是OS较好的独立指标（风险比，0.476；95% CI，0.304 - 0.745；p = 0.001）。
我们的结果表明，AGR值是常规生化检测中易于获得且具有成本效益的标志物，可作为接受靶向治疗的mRCC患者OS的独立预测指标。
