Cheang Iokfai, Li Ying, Zhu Xu, Chen Ziqi, Ren Qing-Wen, Wu Mei-Zhen, Xu Xin, Tse Hung-Fat, Yiu Kai-Hang, Li Xinli
State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Division of Cardiology, Department of Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.
Cancer Med. 2024 Dec;13(23):e70471. doi: 10.1002/cam4.70471.
This study aimed to investigate the clinical value of the glucose-albumin ratio (GAR) in predicting the prognosis of cancer patients prescribed anthracycline-based chemotherapy.
We included cancer patients who underwent anthracycline-based chemotherapy, drawn from the population-based cohort Clinical Data Analysis Reporting System of Hong Kong between January 2000 and December 2019. Demographics, medical history, baseline laboratory, and metabolic indicators, including GAR, were collected. We employed random survival forests (RSF) with the variable importance (VIMP) method to rank the importance of these variables. Cox proportional hazards regression was used to assess the association between GAR levels and event risks.
A total of 18,700 patients were included in the analysis. The top 2 factors for predicting overall cardiovascular event risk were GAR and fasting blood glucose (FBG). Our results revealed that a higher GAR was significantly associated with poorer cardiovascular prognosis in patients with cancer prescribed with anthracycline-based chemotherapy. Compared to the lowest quartile, higher GAR levels were significantly associated with increased risk of all-cause mortality, major adverse cardiovascular events, hospitalization of heart failure, and cardiovascular mortality regardless of the adjustments (all p trend < 0.001).
GAR is a potential biomarker for predicting the prognosis of cancer patients undergoing anthracycline-based chemotherapy. Monitoring GAR levels before and during treatment may help identify patients at higher risk of adverse outcomes, facilitating personalized treatment strategies and improving clinical management.
本研究旨在探讨糖蛋白比(GAR)在预测接受蒽环类化疗的癌症患者预后中的临床价值。
我们纳入了2000年1月至2019年12月期间从香港基于人群的队列临床数据分析报告系统中选取的接受蒽环类化疗的癌症患者。收集了人口统计学、病史、基线实验室检查和代谢指标,包括GAR。我们采用具有变量重要性(VIMP)方法的随机生存森林(RSF)对这些变量的重要性进行排名。使用Cox比例风险回归评估GAR水平与事件风险之间的关联。
共有18700名患者纳入分析。预测总体心血管事件风险的前两个因素是GAR和空腹血糖(FBG)。我们的结果显示,在接受蒽环类化疗的癌症患者中,较高的GAR与较差的心血管预后显著相关。与最低四分位数相比,无论进行何种调整,较高的GAR水平均与全因死亡率、主要不良心血管事件、心力衰竭住院和心血管死亡率增加显著相关(所有p趋势<0.001)。
GAR是预测接受蒽环类化疗的癌症患者预后的潜在生物标志物。在治疗前和治疗期间监测GAR水平可能有助于识别不良结局风险较高的患者,促进个性化治疗策略并改善临床管理。