Department of Surgery, Yokohama City University, Yokohama, Japan.
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
In Vivo. 2021 Nov-Dec;35(6):3555-3561. doi: 10.21873/invivo.12658.
Recent studies have reported that the albumin-to-globulin ratio (AGR) may be a useful inflammatory-nutritional biomarker to predict postoperative complications and poor prognosis in various types of patients with cancer. However, its prognostic value in patients with esophageal cancer is still unclear. We aimed to examine the utility of the AGR for predicting the short- and long-term outcomes in patients with esophageal cancer who underwent curative resection.
This was a retrospective cohort analysis reviewing the medical records of consecutive patients who underwent esophagectomy for clinical stage I to III esophageal cancer at Yokohama City University. A total of 105 patients were identified between 2005 and 2018. The overall survival (OS), recurrence-free survival (RFS), and postoperative complication rates were compared between patients with high AGR (>1.48) and those with low AGR (≤1.48) group.
A total of 57 and 48 patients were classified into the high and low AGR groups, respectively. There was no significant difference between the two groups in the rate of overall postoperative complications of more than Clavien-Dindo grade 3 (50.9% vs. 54.2%, p=0.85). The long-term findings showed that 5-year OS and RFS rates were significantly better for the group with a high AGR (67.2% vs. 33.8%, p<0.001 and 51.6% vs. 28.5%, p=0.003, respectively).
This study suggests that a low preoperative AGR is a risk factor for poor RFS and OS in patients who are planning to undergo curative surgery for esophageal cancer. AGR may be a useful biomarker for establishing treatment strategies to improve patients' survival.
最近的研究报告称，白蛋白与球蛋白比值（AGR）可能是一种有用的炎症-营养生物标志物，可用于预测各种类型癌症患者的术后并发症和不良预后。然而，其在食管癌患者中的预后价值尚不清楚。我们旨在研究 AGR 预测接受根治性切除术的食管癌患者短期和长期结局的效用。
这是一项回顾性队列分析，回顾了在横滨市立大学接受 I 期至 III 期食管癌手术的连续患者的病历。在 2005 年至 2018 年期间，共确定了 105 例患者。比较 AGR 较高（>1.48）和较低（≤1.48）组患者的总生存（OS）、无复发生存（RFS）和术后并发症发生率。
共有 57 例和 48 例患者分别归入 AGR 较高和较低组。两组术后总体并发症发生率（>Clavien-Dindo 分级 3）无显著差异（50.9% vs. 54.2%，p=0.85）。长期结果显示，AGR 较高组的 5 年 OS 和 RFS 率显著更好（67.2% vs. 33.8%，p<0.001 和 51.6% vs. 28.5%，p=0.003）。
本研究表明，术前 AGR 较低是计划接受食管癌根治性手术的患者 RFS 和 OS 不良的危险因素。AGR 可能是改善患者生存的治疗策略的有用生物标志物。
