Wang Zijun, Lin Jinwen, Chen Deping
Gynecology, Fuzhou First General Hospital.
Neonatology, Fujian Provincial Hospital.
Eur J Cancer Prev. 2025 Jul 1;34(4):337-348. doi: 10.1097/CEJ.0000000000000958. Epub 2025 Feb 27.
This study intends to investigate the performance of albumin, globulin, and albumin-globulin ratio (AGR) in predicting the prognosis of patients with cervical cancer. PubMed, Web of Science, Embase, and Cochrane Library databases were searched for relevant articles up to 1 March 2024. To elucidate the prognostic power of albumin, globulin, and AGR in cervical cancer patients, hazard ratios and 95% confidence intervals (CI) were computed. Subgroup analyses were performed to assess the association between albumin and the prognosis of cervical cancer patients. Ten studies involving 2394 cervical cancer patients were enrolled. Our results manifested that low albumin level was linked to poorer overall survival (OS) (hazard ratio = 2.01, 95% CI = 1.45-2.80, p < 0.001), independent of progression-free survival (PFS), whereas high globulin and low AGR were not notably correlated with both OS and PFS. Subgroup analyses by tumor stages, and treatment measures noted that low albumin levels were linked to poorer OS in tumor stages I-II (hazard ratio = 1.96, 95% CI = 1.12-3.43, p = 0.018), I-IV (hazard ratio = 1.96, 95% CI = 1.24-3.10, p = 0.004), and IV (hazard ratio = 3.4, 95% CI = 1.39-8.29, p = 0.007). Low albumin levels were associated with poorer OS in multifactorial analysis (hazard ratio = 1.94, 95% CI = 1.52-2.48, p < 0.001) and survival curves (hazard ratio = 3.38, 95% CI = 1.94-5.88, p < 0.001). In patients undergoing surgery only (hazard ratio = 2.32, 95% CI = 1.70-3.17, p < 0.001) and those with radiotherapy (hazard ratio = 2.12, 95% CI = 1.41-3.2, p < 0.001), low albumin levels were linked to poorer OS, but neither associated with PFS. Low albumin levels in cervical cancer patients are associated with poorer prognoses, and therefore can be viewed as a simple and economical prognostic index for cervical cancer.
本研究旨在探讨白蛋白、球蛋白及白蛋白-球蛋白比值（AGR）在预测宫颈癌患者预后方面的表现。检索了PubMed、Web of Science、Embase和Cochrane图书馆数据库，以查找截至2024年3月1日的相关文章。为阐明白蛋白、球蛋白及AGR对宫颈癌患者的预后预测能力，计算了风险比和95%置信区间（CI）。进行亚组分析以评估白蛋白与宫颈癌患者预后之间的关联。纳入了10项涉及2394例宫颈癌患者的研究。我们的结果表明，低白蛋白水平与较差的总生存期（OS）相关（风险比 = 2.01，95% CI = 1.45 - 2.80，p < 0.001），与无进展生存期（PFS）无关，而高球蛋白和低AGR与OS和PFS均无显著相关性。按肿瘤分期和治疗措施进行的亚组分析指出，在I-II期（风险比 = 1.96，95% CI = 1.12 - 3.43，p = 0.018）、I-IV期（风险比 = 1.96，95% CI = 1.24 - 3.10，p = 0.004）和IV期（风险比 = 3.4，95% CI = 1.39 - 8.29，p = 0.007）肿瘤患者中，低白蛋白水平与较差的OS相关。在多因素分析（风险比 = 1.94，95% CI = 1.52 - 2.48，p < 0.001）和生存曲线分析（风险比 = 3.38，95% CI = 1.94 - 5.88，p < 0.001）中，低白蛋白水平与较差的OS相关。在仅接受手术治疗的患者中（风险比 = 2.32，95% CI = 1.70 - 3.17，p < 0.001）以及接受放射治疗的患者中（风险比 = 2.12，95% CI = 1.41 - 3.2，p < 0.001），低白蛋白水平与较差的OS相关，但与PFS均无关。宫颈癌患者的低白蛋白水平与较差的预后相关，因此可被视为一种简单且经济的宫颈癌预后指标。
