Oymak Ezgi, Guler Ozan Cem, Onal Cem
Division of Radiation Oncology, Iskenderun Gelisim Hospital, Hatay, Turkey.
Department of Radiation Oncology, Baskent University Adana Dr Turgut Noyan Research and Treatment Center, Adana, Turkey.
Int J Gynecol Cancer. 2023 Jan 3;33(1):19-25. doi: 10.1136/ijgc-2022-003768.
Albumin-globulin ratio or albumin-globulin score predict survival in many cancers, but there are few data on cervical cancer patients. This study examined whether pre-treatment albumin and globulin levels, as well as the albumin-globulin ratio and albumin-globulin score, can predict treatment outcomes in cervical cancer patients undergoing definitive chemoradiotherapy.
A retrospective analysis of cervical cancer patients treated between January 2006 and July 2014 was performed. Receiver operating characteristic curves for serum albumin and globulin levels, as well as albumin-globulin ratio values, were generated in order to determine the cut-off values for these parameters and to predict their sensitivity and specificity for predicting recurrence and survival. Univariate and multivariate analyses were used to identify prognostic factors for overall survival and progression-free survival.
A total of 139 patients were included. The median follow-up time was 11.5 years. The 5- and 10-year overall survival rates were 54.7% and 39.3%, while the 5- and 10-year progression-free survival rates were 48.9% and 36.4%, respectively. The optimal cut-off points were 3.79 g/dL for albumin, 3.27 g/dL for globulin, and 1.56 for albumin-globulin ratio. In the univariate analysis, significant prognostic factors for overall survival and progression-free survival were albumin-globulin ratio, albumin-globulin score, patient age, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor size, lymph node metastasis, and treatment response. Older age, advanced stage, low albumin-globulin ratio, albumin-globulin score of 2, and inadequate treatment response had poor overall survival and progression-free survival in multivariable analysis. However, serum albumin and globulin levels were not found to be a significantly predictive factor for survival. There was a significant correlation between albumin levels, globulin levels, tumor size, stage, lymph node metastasis, and treatment response.
Pre-treatment albumin-globulin ratio and albumin-globulin score are useful prognostic factors in patients with cervical squamous cell cancer treated with definitive chemoradiotherapy, and may be suitable biomarkers for predicting treatment outcomes.
白蛋白-球蛋白比值或白蛋白-球蛋白评分可预测多种癌症的生存情况，但关于宫颈癌患者的数据较少。本研究探讨了治疗前白蛋白和球蛋白水平以及白蛋白-球蛋白比值和白蛋白-球蛋白评分是否能预测接受根治性放化疗的宫颈癌患者的治疗结局。
对2006年1月至2014年7月期间接受治疗的宫颈癌患者进行回顾性分析。绘制血清白蛋白和球蛋白水平以及白蛋白-球蛋白比值的受试者工作特征曲线，以确定这些参数的临界值，并预测其预测复发和生存的敏感性和特异性。采用单因素和多因素分析确定总生存和无进展生存的预后因素。
共纳入139例患者。中位随访时间为11.5年。5年和10年总生存率分别为54.7%和39.3%，5年和10年无进展生存率分别为48.9%和36.4%。白蛋白的最佳临界值为3.79g/dL，球蛋白为3.27g/dL，白蛋白-球蛋白比值为1.56。在单因素分析中，总生存和无进展生存的显著预后因素为白蛋白-球蛋白比值、白蛋白-球蛋白评分、患者年龄、国际妇产科联盟（FIGO）分期、肿瘤大小、淋巴结转移和治疗反应。在多因素分析中，年龄较大、分期较晚、白蛋白-球蛋白比值低、白蛋白-球蛋白评分为2以及治疗反应不佳的患者总生存和无进展生存较差。然而，血清白蛋白和球蛋白水平未被发现是生存的显著预测因素。白蛋白水平、球蛋白水平、肿瘤大小、分期、淋巴结转移和治疗反应之间存在显著相关性。
治疗前白蛋白-球蛋白比值和白蛋白-球蛋白评分是接受根治性放化疗的宫颈鳞状细胞癌患者有用的预后因素，可能是预测治疗结局的合适生物标志物。
