Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
National Clinical Research Center for Interventional Medicine, Shanghai 200032, China.
Dis Markers. 2021 Nov 19;2021:3514827. doi: 10.1155/2021/3514827. eCollection 2021.
Albumin to gamma-glutamyltransferase ratio (AGR) is a newly developed biomarker for the prediction of patients' prognosis in solid tumors. The purpose of the study was to establish a novel AGR-based nomogram to predict tumor prognosis in patients with early-stage HCC undergoing radiofrequency ablation (RFA). 394 hepatocellular carcinoma (HCC) patients who had received RFA as initial treatment were classified into the training cohort and validation cohort. Independent prognostic factors were identified by univariate and multivariate analyses. The value of AGR was evaluated by the concordance index (-index), receiver operating characteristic (ROC) curves, and likelihood ratio tests (LAT). Logistic regression and nomogram were performed to establish the pretreatment scoring model based on the clinical variables. As a result, AGR = 0.63 was identified as the best cutoff value to predict overall survival (OS) in the training cohort. According to the results of multivariate analysis, AGR was an independent indicator for OS and recurrence-free survival (RFS). In both training cohort and validation cohort, the high-AGR group showed better RFS and OS than the low-AGR group. What is more, the -index, area under the ROC curves, and LAT values suggested that AGR outperformed the Child-Pugh (CP) grade and albumin-bilirubin (ALBI) grade in terms of predicting OS. The AGR, AKP, and tumor size were used to establish the OS nomogram. Besides, the results of Hosmer-Lemeshow test and calibration curve analysis displayed that both nomograms in the training and validation cohorts performed well in terms of calibration. Therefore, the AGR-based nomogram can predict the postoperative prognosis of early HCC patients undergoing RFA.
白蛋白与γ-谷氨酰转移酶比值（AGR）是一种新开发的用于预测实体瘤患者预后的生物标志物。本研究旨在建立一种新的基于 AGR 的列线图，以预测接受射频消融（RFA）治疗的早期 HCC 患者的肿瘤预后。将 394 名接受 RFA 作为初始治疗的肝细胞癌（HCC）患者分为训练队列和验证队列。通过单因素和多因素分析确定独立的预后因素。通过一致性指数（-index）、接受者操作特征（ROC）曲线和似然比检验（LAT）评估 AGR 的价值。进行逻辑回归和列线图，根据临床变量建立基于术前的评分模型。结果，AGR = 0.63 被确定为训练队列中预测总生存期（OS）的最佳截断值。根据多因素分析的结果，AGR 是 OS 和无复发生存率（RFS）的独立指标。在训练队列和验证队列中，高 AGR 组的 RFS 和 OS 均优于低 AGR 组。更重要的是，-index、ROC 曲线下面积和 LAT 值表明，AGR 在预测 OS 方面优于 Child-Pugh（CP）分级和白蛋白-胆红素（ALBI）分级。基于 AGR、AKP 和肿瘤大小建立了 OS 列线图。此外，训练和验证队列中列线图的 Hosmer-Lemeshow 检验和校准曲线分析结果表明，两个列线图在校准方面均表现良好。因此，基于 AGR 的列线图可以预测接受 RFA 治疗的早期 HCC 患者的术后预后。
