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Zeng X, Wang X, Guan X, Feng X, Lu R, Meng H. The long-term effect of periodontitis treatment on changes in blood inflammatory markers in patients with generalized aggressive periodontitis. J Periodontal Res 2024; 59:689-697. [PMID: 38501229 DOI: 10.1111/jre.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/20/2023] [Accepted: 02/15/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Periodontitis is characterized by local inflammatory conditions in the periodontium, its severe form has been associated with elevated systemic inflammatory markers. However, the long-term effects of periodontal inflammation control on systemic inflammatory markers are unclear. OBJECTIVE This study aimed to investigate the long-term effects of periodontal therapy on the levels of peripheral venous blood inflammatory markers in patients with generalized aggressive periodontitis (GAgP), all of whom were now diagnosed as Stage III or IV Grade C periodontitis. METHODS Patients with GAgP were consecutively recruited from April 2013 to August 2014 (T0). Active periodontal treatment (APT) was provided, and follow-ups were conducted over a 3- to 5-year period (T1). Clinical parameters were assessed and fasting venous blood was collected at T0 and T1. Complete blood cell counts were obtained, and biochemical analyses were performed to evaluate the levels of serum components. The correlations between probing depth (PD) and hematological parameters were analyzed. RESULTS A total of 49 patients with GAgP completed APT and follow-ups. Probing depth (PD) reduced from 5.10 ± 1.07 mm at T0 to 3.15 ± 0.65 mm at T1. For every 1-mm reduction in PD after treatment, the neutrophil count, neutrophil-lymphocyte ratio, and total protein concentration were reduced by 0.33 × 109/L, 0.26, and 1.18 g/L, respectively. In contrast, the albumin/globulin ratio increased by 0.10. CONCLUSION This study indicated that periodontal therapy may have beneficial effects on peripheral venous blood inflammatory markers in patients with GAgP during long-term observation.
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Affiliation(s)
- Xiancheng Zeng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xiane Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xiaoyuan Guan
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Ruifang Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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Xiong Y, Qiao W, Mei T, Li K, Jin R, Zhang Y. Recurrence of Hepatocellular Carcinoma in Patients with Low Albumin-Bilirubin Grade in TACE Combined with Ablation: A Random Forest Cox Predictive Model. J Hepatocell Carcinoma 2024; 11:1375-1388. [PMID: 39005969 PMCID: PMC11245575 DOI: 10.2147/jhc.s465962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/06/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose The aim of our study was to investigate the relationship between albumin-bilirubin (ALBI) grade and recurrence in patients who underwent TACE sequential ablation. We developed and validated a nomogram to predict low levels of ALBI patients' recurrence. Patients and Methods A total of 880 patients undergoing TACE combined ablation at Beijing Youan Hospital from January 2014 to December 2021 were retrospectively enrolled, including 415 patients with L-ALBI (≤-2.6) and 465 patients with high levels (>-2.6) of ALBI (H-ALBI). L-ALBI patients were randomized in a 7:3 ratio into the training cohort (N=289) and validation cohort (N=126). Multivariate Cox regression followed by random survival forest was carried out to identify independent risk factors for prediction nomogram construction. An examination of nomogram accuracy was performed using the C-index, receiver operating characteristic (ROC), calibration curves, and decision curve analysis (DCA) curves. According to the nomogram, the patients were divided into low-risk, intermediate-risk, and high-risk groups. Kaplan-Meier (KM) curves were applied to compare the difference in recurrence-free survival (RFS) among the three groups. Results The median RFS in L-ALBI patients was significantly longer than the H-ALBI patients (40.8m vs 20.1m, HR:1.71, 95% CI:1.44-2.04, P<0.0001). The nomogram was composed of five variables, such as age, Barcelona Clinic Liver Cancer (BCLC) stage, globulin, gamma-glutamyl transferase to lymphocyte ratio (GLR), and international normalized ratio (INR). The C-index (0.722 and 0.731) and 1-, 3-, and 5-year AUCs (0.725, 0.803, 0.870, and 0.764, 0.816, 0.798) of the training and validation cohorts proved the good predictive performance of the nomogram. Calibration curves and DCA curves demonstrated good consistency and good clinical utility. There were significant differences in RFS between the low-risk, intermediate-risk, and high-risk groups (P<0.0001). Conclusion L-ALBI Patients who underwent TACE combined ablation had better recurrence-free survival than patients with H-ALBI. The nomogram developed and validated in our study had good predictive ability in recurrence for L-ALBI patients.
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Affiliation(s)
- Yiqi Xiong
- Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Wenying Qiao
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
- Changping Laboratory, Beijing, 102206, People's Republic of China
| | - Tingting Mei
- Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Kang Li
- Research center for biomedical Resources, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Ronghua Jin
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
- Changping Laboratory, Beijing, 102206, People's Republic of China
| | - Yonghong Zhang
- Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
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Utsumi M, Inagaki M, Kitada K, Tokunaga N, Yunoki K, Sakurai Y, Okabayashi H, Hamano R, Miyasou H, Tsunemitsu Y, Otsuka S. Predictive values of sarcopenia and systemic inflammation-based markers in advanced hepatocellular carcinoma after hepatectomy. Asian J Surg 2024; 47:3039-3047. [PMID: 38388270 DOI: 10.1016/j.asjsur.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Sarcopenia accompanied by systemic inflammation is associated with poor prognosis in patients with advanced hepatocellular carcinoma (HCC). However, the effect of sarcopenia combined with systemic inflammation on the prognosis of patients with advanced HCC who underwent hepatectomy is unclear. This study aimed to evaluate the effect of sarcopenia and inflammation on the prognosis of patients with advanced HCC. METHODS This retrospective study included 151 patients recruited between July 2010 and December 2022. We defined advanced HCC as that presenting with vascular invasion or tumor size ≥2 cm or multiple tumors. Sarcopenia was assessed using the psoas muscle index. Preoperative inflammatory markers were used by calculating the prognostic nutritional index, albumin-globulin ratio (AGR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio. Cox regression analysis was performed to determine the prognostic factors for overall survival. RESULTS Of 151 patients, sarcopenia occurred in 84 (55.6 %). Sarcopenia was significantly associated with male sex, older age, body mass index (<25 kg/m2), and a higher NLR. In the multivariate analysis, AGR <1.25 (hazard ratio [HR], 2.504; 95% confidence interval [CI]: 1.325-4.820; p < 0.05); alpha-fetoprotein levels ≥25 ng/mL (HR, 1.891; 95% CI: 1.016-3.480; p = 0.04); and sarcopenia (HR, 1.908; 95% CI: 1.009-3.776; p < 0.05) were independent predictors of overall survival. The sarcopenia and low AGR groups had significantly worse overall survival than either the non-sarcopenia and high AGR or sarcopenia and low AGR groups. CONCLUSION Sarcopenia and AGR are independent prognostic factors in patients with advanced HCC. Thus, sarcopenia may achieve a better prognostic value when combined with AGR.
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Affiliation(s)
- Masashi Utsumi
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan.
| | - Masaru Inagaki
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Koji Kitada
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Naoyuki Tokunaga
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Kosuke Yunoki
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Yuya Sakurai
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Hiroki Okabayashi
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Ryosuke Hamano
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Hideaki Miyasou
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Yousuke Tsunemitsu
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
| | - Shinya Otsuka
- Department of Surgery, NHO Fukuyama Medical Center, Fukuyama City, Hiroshima, Japan
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Qiao W, Li J, Xiong Y, Zheng J, Jin R, Hu C. GALAD score as a prognostic model for recurrence of hepatocellular carcinoma after local ablation. J Cancer Res Clin Oncol 2024; 150:241. [PMID: 38713414 PMCID: PMC11076334 DOI: 10.1007/s00432-024-05760-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Currently, the high recurrence rate still forms severe challenges in hepatocellular carcinoma (HCC) treatment. The GALAD score, including age, gender, alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP (AFP-L3), and des-gamma-carboxyprothrombin (DCP) was developed as a diagnostic model. However, evidence is still lacking to confirm the capability of the GALAD score to predict the recurrence of HCC. METHODS This study included 390 HCC patients after local ablation at Beijing You'an Hospital from January 1, 2018, to December 31, 2022. Firstly, the area under the receiver operating characteristic (ROC) curve (AUC) was calculated to assess the predictive capability of the GALAD score. Then, the Kaplan-Meier (KM) curve and log-rank test were used to compare the prognosis between two groups classified by GALAD score. Finally, a nomogram for high-risk patients was established by Lasso-Cox regression. It was assessed by ROC curves, calibration curves, and decision curve analysis (DCA). RESULTS The ROC curve (AUC: 0.749) and KM curve showed the GALAD score had good predictive ability and could clearly stratify patients into two groups through the risk of recurrence. Prognostic factors selected by Lasso-Cox regression contained tumor number, tumor size, and globulin. The nomogram for high-risk patients showed reliable discrimination, calibration, and clinical utility. CONCLUSION This research displayed that the GALAD score is an effective model for predicting the recurrence of HCC. Meanwhile, we found the poor prognosis of the high-risk group and created a nomogram for these patients.
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Affiliation(s)
- Wenying Qiao
- Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, People's Republic of China
- Beijing Di'tan Hospital, Capital Medical University, 8 Jingshun East Street, Chaoyang District, Beijing, People's Republic of China
- Changping Laboratory, Beijing, People's Republic of China
| | - Jiashuo Li
- Beijing Di'tan Hospital, Capital Medical University, 8 Jingshun East Street, Chaoyang District, Beijing, People's Republic of China
| | - Yiqi Xiong
- Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, People's Republic of China
| | - Jiasheng Zheng
- Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, People's Republic of China.
| | - Ronghua Jin
- Beijing Di'tan Hospital, Capital Medical University, 8 Jingshun East Street, Chaoyang District, Beijing, People's Republic of China.
- Changping Laboratory, Beijing, People's Republic of China.
| | - Caixia Hu
- Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, People's Republic of China.
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Xiong Y, Qiao W, Wang Q, Li K, Jin R, Zhang Y. Construction and validation of a machine learning-based nomogram to predict the prognosis of HBV associated hepatocellular carcinoma patients with high levels of hepatitis B surface antigen in primary local treatment: a multicenter study. Front Immunol 2024; 15:1357496. [PMID: 38601167 PMCID: PMC11004323 DOI: 10.3389/fimmu.2024.1357496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
Background Hepatitis B surface antigen (HBsAg) clearance is associated with improved long-term outcomes and reduced risk of complications. The aim of our study was to identify the effects of levels of HBsAg in HCC patients undergoing TACE and sequential ablation. In addition, we created a nomogram to predict the prognosis of HCC patients with high levels of HBsAg (≥1000U/L) after local treatment. Method This study retrospectively evaluated 1008 HBV-HCC patients who underwent TACE combined with ablation at Beijing Youan Hospital and Beijing Ditan Hospital from January 2014 to December 2021, including 334 patients with low HBsAg levels and 674 patients with high HBsAg levels. The high HBsAg group was divided into the training cohort (N=385), internal validation cohort (N=168), and external validation cohort (N=121). The clinical and pathological features of patients were collected, and independent risk factors were identified using Lasso-Cox regression analysis for developing a nomogram. The performance of the nomogram was evaluated by C-index, receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) curves in the training and validation cohorts. Patients were classified into high-risk and low-risk groups based on the risk scores of the nomogram. Result After PSM, mRFS was 28.4 months (22.1-34.7 months) and 21.9 months (18.5-25.4 months) in the low HBsAg level and high HBsAg level groups (P<0.001). The content of the nomogram includes age, BCLC stage, tumor size, globulin, GGT, and bile acids. The C-index (0.682, 0.666, and 0.740) and 1-, 3-, and 5-year AUCs of the training, internal validation, and external validation cohorts proved good discrimination of the nomogram. Calibration curves and DCA curves suggested accuracy and net clinical benefit rates. The nomogram enabled to classification of patients with high HBsAg levels into low-risk and high-risk groups according to the risk of recurrence. There was a statistically significant difference in RFS between the two groups in the training, internal validation, and external validation cohorts (P<0.001). Conclusion High levels of HBsAg were associated with tumor progression. The nomogram developed and validated in the study had good predictive ability for patients with high HBsAg levels.
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Affiliation(s)
- Yiqi Xiong
- Interventional Therapy Center for Oncology, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Wenying Qiao
- Research Center for Biomedical Resources, Beijing You’an Hospital Capital Medical University, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Qi Wang
- Interventional Radiology Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Kang Li
- Research Center for Biomedical Resources, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Ronghua Jin
- Research Center for Biomedical Resources, Beijing You’an Hospital Capital Medical University, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yonghong Zhang
- Interventional Therapy Center for Oncology, Beijing You’an Hospital, Capital Medical University, Beijing, China
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Tsukagoshi M, Araki K, Igarashi T, Ishii N, Kawai S, Hagiwara K, Hoshino K, Seki T, Okuyama T, Fukushima R, Harimoto N, Shirabe K. Lower Geriatric Nutritional Risk Index and Prognostic Nutritional Index Predict Postoperative Prognosis in Patients with Hepatocellular Carcinoma. Nutrients 2024; 16:940. [PMID: 38612974 PMCID: PMC11013710 DOI: 10.3390/nu16070940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Increasing evidence suggests that nutritional indices, including the geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI), are predictors of poor prognosis in patients with hepatocellular carcinoma (HCC). Hence, this study aimed to explore the value of the GNRI and PNI in evaluating postoperative prognosis in patients with HCC, particularly regarding its recurrence patterns. We performed a retrospective analysis of 203 patients with HCC who underwent initial hepatic resection. Patients were divided into two groups according to the GNRI (cutoff: 98) and PNI (cutoff: 45). The GNRI and PNI were significantly associated with body composition (body mass index and skeletal muscle mass index), hepatic function (Child-Pugh Score), tumor factors (tumor size and microvascular invasion), and perioperative factors (blood loss and postoperative hospitalization). Patients with a low PNI or low GNRI had significantly worse overall survival (OS) and recurrence-free survival. Patients with early recurrence had lower PNI and GNRI scores than those without early recurrence. Patients with extrahepatic recurrence had lower PNI and GNRI scores than those without extrahepatic recurrence. The PNI and GNRI might be useful in predicting the prognosis and recurrence patterns of patients with HCC after hepatic resection.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Norifumi Harimoto
- Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan; (M.T.); (K.S.)
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Qiao W, Sheng S, Li J, Jin R, Hu C. Machine Learning-Based Nomogram for Predicting Overall Survival in Elderly Patients with Cirrhotic Hepatocellular Carcinoma Undergoing Ablation Therapy. J Hepatocell Carcinoma 2024; 11:509-523. [PMID: 38468611 PMCID: PMC10926877 DOI: 10.2147/jhc.s450825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose The aim of the study is to identify and evaluate multifaceted factors impacting the survival of elderly cirrhotic HCC patients following ablation therapy, with the goal of constructing a nomogram to predict their 3-, 5-, and 8-year overall survival (OS). Patients and Methods A retrospective analysis was conducted on 736 elderly cirrhotic HCC patients who underwent ablation therapy between 2014 and 2022. LASSO regression, random survival forest (RSF), and multivariate Cox analyses were employed to identify independent prognostic factors for OS, followed by the development and validation of a predictive nomogram. Harrell's concordance index (C-index), calibration plot and decision curve analysis (DCA) were used to assess the performance of the nomogram. The nomogram was finally utilized to stratify patients into low-, intermediate-, and high-risk groups, aiming to assess its efficacy in precisely discerning individuals with diverse overall survival outcomes. Results Alcohol drinking, tumor number, globulin (Glob) and prealbumin (Palb) were identified and integrated to establish a novel prognostic nomogram. The nomogram exhibited strong discriminative ability with C-indices of 0.723 (training cohort) and 0.693 (validation cohort), along with significant Area Under the Curve (AUC) values for 3-year, 5-year, and 8-year OS in both cohorts (0.758, 0.770, and 0.811 for training cohort; 0.744, 0.699 and 0.737 for validation cohort). Calibration plots substantiated its consistency, while DCA curves corroborated its clinical utility. The nomogram further demonstrated exceptional effectiveness in discerning distinct risk populations, highlighting its robust applicability for prognostic stratification. Conclusion Our study successfully developed and validated a robust nomogram model based on four key clinical parameters for predicting 3-, 5- and 8-year OS among elderly cirrhotic HCC patients following ablation therapy. The nomogram exhibited a remarkable capability in identifying high-risk patients, furnishing clinicians with invaluable insights for postoperative surveillance and tailored therapeutic interventions.
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Affiliation(s)
- Wenying Qiao
- Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Changping Laboratory, Beijing, People’s Republic of China
- Interventional Therapy Center for Oncology, Beijing You’an Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Shugui Sheng
- Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Junnan Li
- Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Ronghua Jin
- Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Changping Laboratory, Beijing, People’s Republic of China
| | - Caixia Hu
- Interventional Therapy Center for Oncology, Beijing You’an Hospital, Capital Medical University, Beijing, People’s Republic of China
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Qiao W, Fan Z, Wang Q, Jin R, Hu C. Development and Validation of a Nomogram to Predict the Recurrence of HCC Patients Undergoing CECT After Ablation. J Hepatocell Carcinoma 2024; 11:65-79. [PMID: 38235069 PMCID: PMC10793121 DOI: 10.2147/jhc.s441540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
Purpose We first aimed to compare the prognostic difference between the application of Contrast-enhanced computed tomography (CECT) and Non-enhanced computed tomography (NECT) in hepatocellular carcinoma(HCC) patients with early-stage immediately after ablation. We secondly propose to explore the risk factors for recurrence in patients undergoing CECT, and then develop a nomogram. Patients and Methods Clinical data were collected from 711 patients who received TACE combined with ablation from January 1, 2015, to December 31, 2022, at Beijing Youan Hospital. According to the imaging methods applied after ablation, patients were categorized into the CECT group and the NECT group and then were compared by Kaplan-Meier (KM) curves. Lasso regression is used to screen risk factors for recurrence and the nomogram was plotted. Finally, discrimination, calibration plot, and decision curve analysis (DCA) were used to measure the performance of the nomogram. Results The KM curve indicates that recurrence-free survival (RFS) was longer in the CECT group than in the NECT group (HR =0.759, 95% CI 0.606-0.951, P=0.016). Six variables were selected to construct the nomogram. 1-, 3-, and 5-year area under the curves (AUCs) (0.867, 0.731, 0.773 and 0.896, 0.784, 0.773) of the training and validation cohorts proved the good predictive performance of the nomogram. Calibration curves and DCA curves suggested accuracy and net clinical benefit rates. The nomogram enabled to classify of patients into three groups according to the risk of recurrence: low risk, intermediate risk, and high risk. There was a statistically significant difference in RFS between the two groups in the training and validation cohorts (P<0.001). Conclusion We demonstrated that HCC patients who underwent CECT evaluation after ablation had a better prognosis, making this evaluation method highly recommended for guiding clinical management.
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Affiliation(s)
- Wenying Qiao
- Interventional Therapy Center for Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Changping Laboratory, Beijing, People’s Republic of China
| | - Zibo Fan
- Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Qi Wang
- Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Ronghua Jin
- Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Changping Laboratory, Beijing, People’s Republic of China
| | - Caixia Hu
- Interventional Therapy Center for Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
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Li C, Yang X, Li H, Fu Y, Wang W, Jin X, Bian L, Peng L. Postoperative ratio of C-reactive protein to albumin is an independent prognostic factor for gastric cancer. Eur J Med Res 2023; 28:360. [PMID: 37735699 PMCID: PMC10515040 DOI: 10.1186/s40001-023-01334-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE The role of postoperative of the ratio of c-reactive protein to albumin (CRP/Alb ratio) in the prognosis of gastric cancer is rarely evaluated. Our purpose was to investigate the correlation of the postoperative CRP/Alb ratio and long-term prognosis of gastric cancer. METHODS We enrolled 430 patients who suffered from radical gastrectomy. The commonly used inflammatory indices, clinical-pathological characteristics and oncologic outcomes were recorded. The median was used to the cut-off value for preoperative and postoperative CRP/Alb ratio, respectively. Kaplan-Meier analysis and Cox proportional hazards regression model were performed to determine its prognostic significance. RESULTS In univariate analysis, there were significant differences were observed in overall survival (OS) according to perioperative CRP/Alb ratio, c-reactive protein (CRP), serum albumin (Alb), respectively. According to the multivariate analysis, higher postoperative CRP/Alb ratio (HR 2.03, 95% CI 1.55-2.66, P < 0.001), lower postoperative albumin (Alb), higher preoperative c-reactive protein (CRP) and higher postoperative CRP were indicated a shorter overall survival. CONCLUSION Postoperative inflammatory factors in patients with gastric cancer should be pay attention, especially postoperative CRP/Alb ratio may be an independent predictor of long-term prognosis of gastric cancer.
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Affiliation(s)
- Chenxi Li
- Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Xuhui Yang
- Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Hui Li
- Department of Oncology, The Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Yan Fu
- Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Wenying Wang
- Senior Department of Obstetrics & Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Xin Jin
- Senior Department of Hepato-Pancreato-Biliary Surgery, The First Medical Center of PLA General Hospital, Beijing, China
| | - Lihua Bian
- Department of Obstetrics and Gynecology, Hainan Hospital of PLA General Hospital, Sanya, China
| | - Liang Peng
- Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
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10
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Roberts WS, Delladio W, Price S, Murawski A, Nguyen H. The efficacy of albumin-globulin ratio to predict prognosis in cancer patients. Int J Clin Oncol 2023; 28:1101-1111. [PMID: 37421476 DOI: 10.1007/s10147-023-02380-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
The goal of this systematic review was to identify all of the research within the last 10 years that investigated both the Albumin-Globulin Ratio (AGR) and outcomes of solid tumor cancer patients via quantitative prognostic variables. Multiple scientific databases were researched for journal articles that included keywords relating AGR to prognosis. Once isolated from the databases, the articles were de-duplicated and manually screened based on standardized inclusion/exclusion criteria in a blind format via Rayyan. The collective data were sorted by cancer type, corrected for population size, and used to calculate the average cut-off values for the most popular prognostic variables. In total, 18 independent types of cancer have been evaluated to see if AGR is a prognostic indicator based on multivariate analyses. The average cut-off value for AGR in overall survival was 1.356, while the average cut-off value for AGR in progression free survival was 1.292. AGR was found to be significantly associated with at least one prognostic variable in every type of cancer evaluated based on multivariate analyses. The ease of access and affordability of AGR makes it an invaluable tool applicable to nearly all patients. Overall, AGR is a proven prognostic variable that should always be considered in the evaluation of a solid tumor cancer patient's prognosis. Further research needs to be conducted studying the potential prognostic effect in more types of solid tumors.
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Affiliation(s)
- Will S Roberts
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA.
| | - William Delladio
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Shawn Price
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Alec Murawski
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Hoang Nguyen
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
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11
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Mao H, Yang F. Prognostic significance of albumin-to-globulin ratio in patients with renal cell carcinoma: a meta-analysis. Front Oncol 2023; 13:1210451. [PMID: 37538115 PMCID: PMC10394642 DOI: 10.3389/fonc.2023.1210451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Background Whether the albumin-to-globulin ratio (AGR) predicts the prognosis of renal cell carcinoma (RCC) remains controversial. Herein, we performed a meta-analysis to critically evaluate the relationship between the AGR and RCC prognosis, as well as the association between the AGR and the clinicopathological characteristics of RCC. Methods The PubMed, Web of Science, Embase, and Cochrane Library databases were thoroughly and comprehensively searched from their inception until 24 June 2023. To determine the predictive significance of the AGR, hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated from the pooled data. The relationship between the AGR and the clinicopathological features of RCC was evaluated by estimating odds ratios (ORs) and 95% CIs in subgroup analyses. Results The meta-analysis included nine articles involving 5,671 RCC cases. A low AGR significantly correlated with worse overall survival (OS) (HR = 1.82, 95% CI = 1.37-2.41, p <0.001) and progression-free survival (PFS) (HR = 2.44, 95% CI = 1.61-3.70, p <0.001). Analysis of the pooled data also revealed significant associations between a low AGR and the following: female sex (OR = 1.48, 95% CI = 1.31-1.67, p <0.001), pT stage T3-T4 (OR = 4.12, 95% CI = 2.93-5.79, p <0.001), pN stage N1 (OR = 3.99, 95% CI = 2.40-6.64, p <0.001), tumor necrosis (OR = 3.83, 95% CI = 2.23-6.59, p <0.001), and Fuhrman grade 3-4 (OR = 1.82, 95% CI = 1.34-2.42, p <0.001). The AGR was not related to histology (OR = 0.83, 95% CI = 0.60-1.15, p = 0.267). Conclusion In patients with RCC, a low AGR strongly predicted poor OS and PFS and significantly correlated with clinicopathological features indicative of disease progression.
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Affiliation(s)
- Huaying Mao
- Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China
| | - Fan Yang
- Clinical Laboratory, Huzhou Maternity and Child Health Care Hospital, Huzhou, Zhejiang, China
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12
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Li J, Li Z, Hao S, Wang J, Chen W, Dai S, Hou Z, Chen B, Zhang Y, Liu D. Inversed albumin-to-globulin ratio and underlying liver disease severity as a prognostic factor for survival in hepatocellular carcinoma patients undergoing transarterial chemoembolization. Diagn Interv Radiol 2023; 29:520-528. [PMID: 36992824 PMCID: PMC10679613 DOI: 10.5152/dir.2022.211166] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/14/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Previous studies have shown that an inversed albumin-to-globulin ratio (IAGR) is a predictor of the prognosis of many cancers. However, the prognostic value of an IAGR for patients with hepatocellular carcinoma (HCC) who undergo transarterial chemoembolization (TACE) is still unclear. This study aims to evaluate the predictive value of an IAGR for the prognosis of those patients. METHODS This study retrospectively analyzed 396 patients with HCC who received TACE. Using a cut-off value of 1.0 for the albumin-to-globulin ratio, patients were divided into a normal albumin-to-globulin ratio (NAGR) (≥1) and an IAGR (<1) group. Univariate and multivariate analyses and time-dependent receiver operating characteristic analyses were performed to identify risk factors of overall survival (OS) and cancer-specific survival (CSS). Survival nomograms were constructed based on the multivariable analysis results and further evaluated using the consistency index (C-index) and calibration curve. RESULTS A total of 396 patients were included in the final analysis and were divided into the NAGR group (n = 298, 75.3%) and the IAGR (n = 98, 24.7%) group. The median OS and CSS were significantly worse in the IAGR group than in the NAGR group (OS: 8 vs. 26 months, CSS: 10 vs. 41 months, both P < 0.001). Multivariate analyses demonstrated that an IAGR was an independent risk factor for predicting worse OS [hazard ratio (HR), 2.024; 95% confidence interval (CI): 1.460-2.806] and CSS (HR: 2.439; 95% CI: 1.651-3.601). The nomogram-based model-related C-indexes for OS and CSS prediction were 0.715 (95% CI: 0.697-0.733) and 0.750 (95% CI: 0.729-0.771), and the calibration of the nomogram showed good consistency. CONCLUSION The IAGR along with underlying liver disease severity were the useful prognostic predictors of OS and CSS among patients with HCC undergoing TACE and might be useful to identify high-risk patients.
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Affiliation(s)
- Jinlong Li
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
| | - Zhi Li
- Department of Infection Management, Xingtai General Hospital of North China Healthcare Group, Hebei, China
| | - Shirui Hao
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
| | - Jitao Wang
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
- School of Medicine, Southeast University Faculty of Medicine, Nanjing, China
| | - Wei Chen
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
| | - Shoufang Dai
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
| | - Zhenguo Hou
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
| | - Borun Chen
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
| | - Yewei Zhang
- Department of Infection Management, Xingtai General Hospital of North China Healthcare Group, Hebei, China
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Dengxiang Liu
- Xingtai Institute of Cancer Control, Xingtai People’s Hospital, Hebei, China
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Kuhlmann AD, Spies C, Schulte E, Jara M, von Haefen C, Mertens M, Süß LA, Winkler N, Lachmann G, Lachmann C. Preoperative hypoalbuminaemia in liver surgery: an observational study at a university medical centre. BMJ Open 2023; 13:e068405. [PMID: 37202140 DOI: 10.1136/bmjopen-2022-068405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES Preoperative hypoalbuminaemia is associated with adverse outcome, including increased postoperative mortality in cardiovascular surgery, neurosurgery, trauma and orthopaedic surgery. However, much less is known about the association between preoperative serum albumin and clinical outcomes after liver surgery. In this study, we sought to determine whether hypoalbuminaemia before partial hepatectomy is associated with a worse postoperative outcome. DESIGN Observational study. SETTING University Medical Centre in Germany. PARTICIPANTS We analysed 154 patients enrolled in the perioperative PHYsostigmine prophylaxis for liver resection patients at risk for DELIrium and postOperative cognitive dysfunction (PHYDELIO) trial with a preoperative serum albumin assessment. Hypoalbuminaemia was defined as serum albumin <35 g/L. Subgroups classified as hypoalbuminaemia and non-hypoalbuminaemia consisted of 32 (20.8%) and 122 (79.2%) patients, respectively. OUTCOME MEASURES The outcome parameters of interest were postoperative complications according to Clavien (moderate: I, II; major: ≥III), length of intensive care unit (ICU) stay, length of hospital stay and survival rates 1 year after surgery. RESULTS Preoperative hypoalbuminaemia was associated with the occurrence of major postoperative complications (OR 3.051 (95% CI 1.197 to 7.775); p=0.019) after adjusting for age, sex, randomisation, American Society of Anesthesiologists physical status, preoperative diagnosis and Child-Pugh class. Both ICU and hospital lengths of stay were significantly prolonged in patients with preoperative hypoalbuminaemia (OR 2.573 (95% CI 1.015 to 6.524); p=0.047 and OR 1.296 (95% CI 0.254 to 3.009); p=0.012, respectively). One-year survival was comparable between patients with and without hypoalbuminaemia. CONCLUSIONS We found that low serum albumin before surgery was associated with a worse short-term outcome after partial hepatectomy, which strengthens the prognostic value of serum albumin in the setting of liver surgery. TRIAL REGISTRATION NUMBERS ISRCTN18978802 and EudraCT 2008-007237-47.
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Affiliation(s)
- Anna Dorothea Kuhlmann
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Spies
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Erika Schulte
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maximilian Jara
- Department of Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Clarissa von Haefen
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mandy Mertens
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Laura Anouk Süß
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nathalie Winkler
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gunnar Lachmann
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Cornelia Lachmann
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
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14
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Yu X, Yang R, He Z, Zeng P. Construction and validation of a nomogram for hepatocellular carcinoma patients treated by traditional Chinese medicine based on inflammation, nutrition, and blood lipid indicators. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04830-y. [PMID: 37160627 DOI: 10.1007/s00432-023-04830-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 04/30/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE To establish a nomogram for hepatocellular carcinoma (HCC) patients treated by traditional Chinese medicine (TCM). METHODS Clinical cases of HCC patients treated by TCM at Hunan Integrated Traditional Chinese and Western Medicine Hospital, and it was randomly divided into the training cohort (n = 222) and the validation cohort (n = 95). In the training cohort, independent risk factors were determined by Cox regression analysis and a nomogram was constructed. The efficiency and clinical applicability of nomograms were evaluated using time-dependent curves, calibration, and the decision curve (DCA), and the patients were divided into high-risk, middle-risk and low-risk groups using X-tile software. RESULTS Multivariate Cox regression analysis screened 6 independent risk factors to construct a nomogram of HCC patients, including TNM stage, treatment methods, high-density lipoprotein (HDL), neutrophil-to-lymphocyte ratio (NLR), albumin-to-globulin ratio (AGR), and prognostic nutritional index (PNI). The consistency index (C-index) of the nomogram of the training was 0.811 (0.794-0.829) and the validation cohort was 0.825 (0.800-0.849). The time dependency showed the AUC values of the nomogram for 3 and 5 years in training cohort were 0.894 (95% CI 0.840-0.948) and 0.952 (95% CI 0.914-0.990), and the validation cohort were 0.928 (95% CI 0.865-0.990) and 0.96 3(95% CI 0.916-1.010). The calibration plot showed the nomogram fits well onto perfect curves, and the DCA curve showed the net benefit of the nomogram at a certain probability threshold is significantly higher than the net benefit of the TNM stage at the same threshold probability. Finally, all the patients were divided into high-risk, middle-risk and low-risk groups based on the total score of nomogram, and it showed effectively how to identify to high-risk patients. CONCLUSION The nomogram established by the independent risk factors of TNM stage, treatment methods, HDL, AGR, NLR and PNI can predict the prognosis of HCC patients treated by TCM, providing an effective tool to clinical workers to evaluate the prognosis and survival time of HCC patients.
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Affiliation(s)
- Xiaopeng Yu
- Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Renyi Yang
- Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Zuomei He
- Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, Changsha, 410006, Hunan, China.
- Cancer Research Institute of Hunan Academy of Traditional Chinese Medicine, Changsha, 410006, Hunan, China.
| | - Puhua Zeng
- Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, Changsha, 410006, Hunan, China.
- Cancer Research Institute of Hunan Academy of Traditional Chinese Medicine, Changsha, 410006, Hunan, China.
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15
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Qi H. Role and research progress of hematological markers in laryngeal squamous cell carcinoma. Diagn Pathol 2023; 18:50. [PMID: 37081512 PMCID: PMC10120220 DOI: 10.1186/s13000-023-01335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023] Open
Abstract
Laryngeal cancer is one of the most common malignant tumors of the head and neck, accounting for about 20%. Due to its high disability rate, the diagnosis and treatment of laryngeal cancer have always been the focus and difficulty of head and neck surgery. The outcome of cancer is affected not only by tumor-related factors but also by host-related factors, especially systemic inflammation, this is usually reflected by a variety of hematological markers. Studies have confirmed that there is a significant correlation between hematological markers and the occurrence, development, and prognosis of laryngeal squamous cell carcinoma (LSCC), and has a certain value in auxiliary diagnosis and prognosis prediction of LSCC. We reviewed various hematological markers related to LSCC aim to summarize the role and research progress of hematological markers in LSCC.
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Affiliation(s)
- Hui Qi
- Nursing College, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
- Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
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16
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Wang A, Zhang Y, Xia G, Tian X, Zuo Y, Chen P, Wang Y, Meng X, Han X. Association of serum albumin to globulin ratio with outcomes in acute ischemic stroke. CNS Neurosci Ther 2023; 29:1357-1367. [PMID: 36794538 PMCID: PMC10068453 DOI: 10.1111/cns.14108] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Serum albumin to globulin ratio (A/G) has been widely used as a representative biomarker for assessing inflammation and nutrition status. However, in patients with acute ischemic stroke (AIS), the predictive value of serum A/G has rarely been reported. We aimed to evaluate whether serum A/G is associated with prognosis in stroke. METHODS We analyzed data from the Third China National Stroke Registry. The patients were categorized into quartile groups according to the serum A/G at admission. Clinical outcomes included poor functional outcomes (modified Rankin Scale [mRS] score of 3-6 or 2-6) and all-cause mortality at 3 months and1 year. Multivariable logistic regressions and Cox proportional hazards regressions were used to evaluate the association of serum A/G with the risk of poor functional outcomes and all-cause mortality. RESULTS A total of 11, 298 patients were included in this study. After adjustment for confounding factors, patients in the highest serum A/G quartile had a lower proportion of mRS score 2-6 (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.76-1.00) and mRS score 3-6 (OR, 0.87; 95% CI, 0.73-1.03) at 3 months follow-up. At 1 year follow-up, there was a significant association between higher serum A/G and mRS score 3-6 (OR, 0.68; 95% CI, 0.57-0.81). We also found that the highest serum A/G was related to decreased risk of all-cause mortality (hazard ratio [HR], 0.58; 95% CI, 0.36-0.94) at 3 months follow-up. Similar results were found at 1-year follow-up. CONCLUSIONS Lower serum A/G levels were associated with poor functional outcomes and all-cause mortality at 3 months and 1-year follow-up in patients with acute ischemic stroke.
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Affiliation(s)
- Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Guangxin Xia
- Department of Neurology, Kaifeng Central Hospital, Kaifeng, China
| | - Xue Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yingting Zuo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Pan Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinsheng Han
- Department of Neurology, Kaifeng Central Hospital, Kaifeng, China
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17
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Jeng LB, Chan WL, Teng CF. Prognostic Significance of Serum Albumin Level and Albumin-Based Mono- and Combination Biomarkers in Patients with Hepatocellular Carcinoma. Cancers (Basel) 2023; 15:cancers15041005. [PMID: 36831351 PMCID: PMC9953807 DOI: 10.3390/cancers15041005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer. Although many surgical and nonsurgical therapeutic options have been established for treating HCC, the overall prognosis for HCC patients receiving different treatment modalities remains inadequate, which causes HCC to remain among the most life-threatening human cancers worldwide. Therefore, it is vitally important and urgently needed to develop valuable and independent prognostic biomarkers for the early prediction of poor prognosis in HCC patients, allowing more time for more timely and appropriate treatment to improve the survival of patients. As the most abundant protein in plasma, human serum albumin (ALB) is predominantly expressed by the liver and exhibits a wide variety of essential biological functions. It has been well recognized that serum ALB level is a significant independent biomarker for a broad spectrum of human diseases including cancer. Moreover, ALB has been commonly used as a potent biomaterial and therapeutic agent in clinical settings for the treatment of various human diseases. This review provides a comprehensive summary of the evidence from the up-to-date published literature to underscore the prognostic significance of serum ALB level and various ALB-based mono- and combination biomarkers in the prediction of the prognosis of HCC patients after treatment with different surgical, locoregional, and systemic therapies.
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Affiliation(s)
- Long-Bin Jeng
- Organ Transplantation Center, China Medical University Hospital, Taichung 404, Taiwan
- Department of Surgery, China Medical University Hospital, Taichung 404, Taiwan
- Cell Therapy Center, China Medical University Hospital, Taichung 404, Taiwan
| | - Wen-Ling Chan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
- Epigenome Research Center, China Medical University Hospital, Taichung 404, Taiwan
| | - Chiao-Fang Teng
- Organ Transplantation Center, China Medical University Hospital, Taichung 404, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
- Program for Cancer Biology and Drug Development, China Medical University, Taichung 404, Taiwan
- Research Center for Cancer Biology, China Medical University, Taichung 404, Taiwan
- Correspondence: ; Tel.: +886-4-2205-2121; Fax: +886-4-2202-9083
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18
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Ulloque-Badaracco JR, Mosquera-Rojas MD, Hernandez-Bustamante EA, Alarcón-Braga EA, Herrera-Añazco P, Benites-Zapata VA. Prognostic value of albumin-to-globulin ratio in COVID-19 patients: A systematic review and meta-analysis. Heliyon 2022; 8:e09457. [PMID: 35601226 PMCID: PMC9113764 DOI: 10.1016/j.heliyon.2022.e09457] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/21/2022] [Accepted: 05/12/2022] [Indexed: 12/11/2022] Open
Abstract
Background and aims The albumin-to-globulin ratio (AGR) has been used to predict severity and mortality in infectious diseases. The aim of this study is to evaluate the prognostic value of the AGR in COVID-19 patients. Methods A systematic review and meta-analysis were conducted. We included observational studies assessing the association between the AGR values upon hospital admission and severity or all-cause mortality in COVID-19 patients. In the meta-analyses we used random effect models. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The effect measures were expressed as mean difference (MD) and their 95% confidence intervals (CI). We performed Egger's test and funnel plots to assess the publication bias. Results The included studies had a total of 11356 patients corresponding to 31 cohort studies. Severe COVID-19 patients had lower AGR values than non-severe COVID-19 patients (mean difference (MD), −0.27; 95% IC, −0.32 to −0.22; p < 0.001; I2 = 88%). Non-survivor patients with COVID-19 had lower AGR values than survivor patients (MD, −0.29; 95% IC, −0.35 to −0.24; p < 0.001; I2 = 79%). In the sensitivity analysis, we only included studies with low risk of bias, which decreased the heterogeneity for both outcomes (severity, I2 = 20%; mortality, I2 = 5%). Conclusions Low AGR values upon hospital admission were found in COVID-19 patients with a worse prognosis.
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Affiliation(s)
- Juan R Ulloque-Badaracco
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Melany D Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Enrique A Hernandez-Bustamante
- Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru.,Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Esteban A Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Percy Herrera-Añazco
- Universidad Privada San Juan Bautista, Lima, Peru.,Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru
| | - Vicente A Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
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19
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Yang D, Shen J, Huang H, Wang J, Sun F, Zeng T, Qiu H, Xie H, Chen Y, Li S, Chen Y, Chen G, Weng Y. Elevated Albumin to Globulin Ratio on Day 7 is Associated with Improved Function Outcomes in Acute Ischemic Stroke Patients with Intravenous Thrombolysis. J Inflamm Res 2022; 15:2695-2705. [PMID: 35505797 PMCID: PMC9057231 DOI: 10.2147/jir.s347026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 03/29/2022] [Indexed: 12/28/2022] Open
Abstract
Background and Purpose Albumin to globulin ratio (A/G) has been established as a representative biomarker for assessing inflammation and nutritional status. However, the prognostic value of A/G has rarely been reported in acute ischemic stroke (AIS) patients with intravenous thrombolysis (IVT). Methods A total of 311 AIS patients who had undergone IVT and completed 3-month follow-up were retrospectively recruited in this study. Albumin (Alb), globulin (Glb) and A/G on admission, within 24 hours after IVT and on day 7 were recorded. Poor outcome was defined as death or major disability (modified Rankin Scale, 3–6) at 3 months. Results Among the 311 cases, 260 patients had admission blood samples, 296 cases had blood samples within 24 hours after IVT and 126 cases had blood samples on day 7. The patients with and without available blood samples were well-balanced. During the first 24 h, we observed A/G to increase significantly compared with baseline whereas at day 7 it was almost back to baseline in patients with a poor outcome. Receiver operating characteristic (ROC) curves analysis showed that A/G had a better performance in discriminating patients at high risk and low risk of a poor outcome than either Alb or Glb alone and carried the highest predictive ability on day 7 (AUC = 0.807). Lower 7-day A/G was independently associated with a poor outcome (per-SD increase, OR = 0.182, 95% CI: 0.074–0.446). Conclusion A/G is an important prognostic indicator for AIS outcomes and merits dynamic monitoring.
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Affiliation(s)
- Dehao Yang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Correspondence: Dehao Yang, Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, People’s Republic of China, Email ; Yiyun Weng, Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People’s Republic of China, Email
| | - Jiamin Shen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Honghao Huang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Jianing Wang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Fangyue Sun
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Tian Zeng
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Haojie Qiu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the Second Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Haobo Xie
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yilin Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Shengqi Li
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yiqun Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Guangyong Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yiyun Weng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
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Ma Y, Shang K, Wu S, Wang J, Cao B. The Prognostic Value of Albumin-Globulin Ratio and Eosinophil-Neutrophil Ratio in Patients with Advanced Tumors Undergoing Treatment with PD-1/PD-L1 Inhibitors. Nutr Cancer 2022; 74:2815-2828. [PMID: 35102801 DOI: 10.1080/01635581.2022.2032764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We investigated the prognostic value of peripheral serum biomarkers, including albumin-globulin ratio (AGR) and eosinophil-neutrophil ratio (ENR), in patients with advanced tumors treated with PD-1/PD-L1 inhibitors. We also retrospectively analyzed the clinical efficacy of PD-1/PD-L1 inhibition in 95 patients with advanced tumors treated at our center. The prognostic value of baseline AGR, baseline ENR, and baseline neutrophil-lymphocyte ratio (NLR) in the serum were evaluated. We also developed a risk scoring tool to stratify patients based on their prognosis. Univariate Cox regression analysis revealed that age, NLR, Eastern Cooperative Oncology Group (ECOG) performance status (PS), platelet-neutrophil ratio (PLR), ENR, AGR, lactate dehydrogenase levels, treatment line, and treatment type were correlated with progression-free survival (PFS). Multivariate Cox regression analysis showed that age, AGR, ENR, and treatment type were independent prognostic factors for PFS. Patients in the low-risk group had significantly longer PFS than those in the high-risk group. The nomogram concordance index (C-index) was 0.716. Patients with a decrease in AGR of over 20% after the first and second treatment cycles had significantly worse PFS than those without decreased AGR. These findings suggest that baseline AGR and ENR may be useful prognostic biomarkers for patients with advanced tumors treated with PD-1/PD-L1 inhibitors.
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Affiliation(s)
- Yan Ma
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Kun Shang
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Shanshan Wu
- Department of Clinical Epidemiology and EBM, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Jing Wang
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
| | - Bangwei Cao
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, Xicheng District, China
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Deng Y, Zhang F, Sun ZG, Wang S. Development and Validation of a Prognostic Signature Associated With Tumor Microenvironment Based on Autophagy-Related lncRNA Analysis in Hepatocellular Carcinoma. Front Med (Lausanne) 2022; 8:762570. [PMID: 34970559 PMCID: PMC8712323 DOI: 10.3389/fmed.2021.762570] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/15/2021] [Indexed: 12/11/2022] Open
Abstract
Objective: The present study aimed to establish a prognostic signature based on the autophagy-related long non-coding RNAs (lncRNAs) analysis in patients with hepatocellular carcinoma (HCC). Methods: Patients with HCC from The Cancer Genome Atlas (TCGA) were taken as the training cohort, and patients from the International Cancer Genome Consortium (ICGC) were treated as the validation cohort. Autophagy-related lncRNAs were obtained via a co-expression network analysis. According to univariate and multivariate analyses, a multigene prognostic signature was constructed in the training cohort. The predictive power of the signature was confirmed in both cohorts. The detailed functions were investigated using functional analysis. The single-sample gene set enrichment analysis (ssGSEA) score was used to evaluate the tumor microenvironment. The expression levels of immunotherapy and targeted therapy targets between the two risk groups were compared. Finally, a nomogram was constructed by integrating clinicopathological parameters with independently predictive value and the risk score. Results: Four autophagy-related lncRNAs were identified to establish a prognostic signature, which separated patients into high- and low-risk groups. Survival analysis showed that patients in the high-risk group had a shorter survival time in both cohorts. A time-independent receiver-operating characteristic (ROC) curve and principal component analysis (PCA) confirmed that the prognostic signature had a robust predictive power and reliability in both cohorts. Functional analysis indicated that the expressed genes in the high-risk group are mainly enriched in autophagy- and cancer-related pathways. ssGSEA revealed that the different risk groups were associated with the tumor microenvironment. Moreover, the different risk groups had positive correlations with the expressions of specific mutant genes. Multivariate analysis showed that the risk score also exhibited excellent predictive power irrespective of clinicopathological characteristics in both cohorts. A nomogram was established. The nomogram showed good discrimination, with Harrell's concordance index (C-index) of 0.739 and good calibration. Conclusion: The four autophagy-related lncRNAs could be used as biological biomarkers and therapeutic targets. The prognostic signature and nomogram might aid clinicians in individual treatment optimization and clinical decision-making for patients with HCC.
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Affiliation(s)
- Yan Deng
- Department of Hepatobiliary Surgery, Jing Zhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jing Zhou, China
| | - Feng Zhang
- Department of Ophthalmology, Jing Zhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jing Zhou, China
| | - Zhen-Gang Sun
- Department of Hepatobiliary Surgery, Jing Zhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jing Zhou, China
| | - Shuai Wang
- Department of Hepatobiliary Surgery, Jing Zhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jing Zhou, China
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22
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Guven DC, Aktepe OH, Aksun MS, Sahin TK, Kavgaci G, Ucgul E, Cakir IY, Yildirim HC, Guner G, Akin S, Kertmen N, Dizdar O, Aksoy S, Erman M, Yalcin S, Kilickap S. The association between albumin-globulin ratio (AGR) and survival in patients treated with immune checkpoint inhibitors. Cancer Biomark 2021; 34:189-199. [PMID: 34958005 DOI: 10.3233/cbm-210349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The albumin-globulin ratio (AGR) could be a prognostic biomarker in patients with cancer, although the data is limited in patients treated with immune-checkpoint inhibitors (ICIs). OBJECTIVES We aimed to evaluate the association between AGR and survival in ICI-treated patients. METHODS The data of 212 advanced-stage patients were retrospectively evaluated in this cohort study. The association between AGR with overall (OS) and progression-free survival (PFS) were evaluated with multivariate analyses. Additionally, receptor operating curve (ROC) analysis was conducted to assess the AGR's predictive power in the very early progression (progression within two months) and long-term benefit (more than twelve months survival). RESULTS The median AGR was calculated as 1.21, and patients were classified into AGR-low and high subgroups according to the median. In the multivariate analyses, patients with lower AGR (< 1.21) had decreased OS (HR: 1.530, 95% CI: 1.100-2.127, p= 0.011) and PFS (HR: 1.390, 95% CI: 1.020-1.895, p= 0.037). The area under curve of AGR to detect early progression and long-term benefit were 0.654 (95% CI: 0.562-0.747, p= 0.001) and 0.671 (95% CI: 0.598-0.744, p< 0.001), respectively. CONCLUSIONS In our experience, survival with ICIs was impaired in patients with lower AGR. Additionally, the AGR values could detect the very early progression and long-term benefit ICIs.
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Affiliation(s)
| | | | - Melek Seren Aksun
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Taha Koray Sahin
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gozde Kavgaci
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Enes Ucgul
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ibrahim Yahya Cakir
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Gurkan Guner
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Serkan Akin
- Hacettepe University Cancer Institute, Ankara, Turkey
| | | | - Omer Dizdar
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Sercan Aksoy
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Suayib Yalcin
- Hacettepe University Cancer Institute, Ankara, Turkey
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Ford HR, Busato S, Trevisi E, Muchiri RN, van Breemen RB, Bionaz M, Ates S. Effects of Pasture Type on Metabolism, Liver and Kidney Function, Antioxidant Status, and Plant Secondary Compounds in Plasma of Grazing, Jersey Dairy Cattle During Mid-lactation. FRONTIERS IN ANIMAL SCIENCE 2021. [DOI: 10.3389/fanim.2021.729423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Some pasture species are rich in phytochemicals, able to improve milk yield and quality and to reduce the environmental impacts of livestock farming. The phytochemicals interact with the different gene networks within the animal, such as nuclear factor erythroid 2-related factor 2 (NRF2), but their overall impact on animal health remains to be fully understood. The objective of this study was to identify the effects of pasture Legumes and non-leguminous Forbs containing high bioactive compounds on metabolism and activity of the liver, antioxidant response, kidney function, and inflammation of dairy cows using a large array of blood parameters associated with metabolism and the innate immune system. For this purpose, 26 parameters and the concentration of certain bioactive compounds were assessed in blood plasma, collected from the Jersey cows grazing either Grass, Legume, or Forb-based pastures. In addition, serum collected from all the cows was utilized to detect the changes in NRF2 activation in bovine mammary alveolar cells (MACT) and hepatocytes. Compared with Grass, the cows that grazed both Forb and Legume pastures had lower β-hydroxybutyric acid (BHB) and creatinine and larger vitamin E and the ferric reducing ability of the plasma, supporting an improved antioxidative status for these animals. Compared with both Grass and Legume, the cows that graze Forb pasture had lower urea and urea to creatinine ratio, and lower creatinine, indicating a better kidney function. The cows grazing Legume pasture had greater hematocrit, bilirubin, cholesterol, albumin, β-carotene, retinol, and thiol groups but lower ceruloplasmin, paraoxonase, and myeloperoxidase (MPO) than those grazed Grass and Forb pastures, indicating a positive effect of Legume pasture on the liver, oxidative stress, and red blood cells. The plasma of cows in the various pastures was enriched with various isoflavonoids, especially the cows grazed on Forb and Legume pastures, which likely contributed to improving the antioxidative status of those cows. However, this effect was likely not due to the higher activation of NRF2. Overall, these results indicate that Forb and Legume pastures rich in secondary metabolites do not strongly affect the metabolism but can improve the status of the liver and the kidney and improve the efficiency of N utilization and antioxidant response, compared with the Grass pasture.
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Utsumi M, Kitada K, Tokunaga N, Narusaka T, Hamano R, Miyasou H, Tsunemitsu Y, Otsuka S, Inagaki M. Preoperative Albumin-to-Globulin Ratio Predicts Prognosis in Hepatocellular Carcinoma: A Cohort Study Including Non-Hepatitis Virus-Infected Patients. Dig Surg 2021; 38:307-315. [PMID: 34515102 DOI: 10.1159/000518307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/02/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION We evaluated the prognostic significance of the preoperative albumin-to-globulin ratio (AGR) in patients with hepatocellular carcinoma (HCC) with various liver etiologies. METHODS We retrospectively analyzed 157 patients with HCC between July 2010 and February 2021. The relationship between clinicopathological variables was investigated using univariate and multivariate analyses. Statistical significance was set at p < 0.05. RESULTS The mean overall survival (OS) was 24.5 months. The 1-, 3-, and 5-year OS rates were 90.4%, 81.2%, and 68.7%, respectively. Patients were classified into 2 groups: AGR <1.16 (low-AGR group; n = 43) and AGR ≥1.16 (high-AGR group; n = 114). In univariate analysis, OS was significantly reduced in patients with a low AGR (AGR <1.16), an alpha-fetoprotein level ≥25 ng/mL, a tumor size ≥3.5 cm, microvascular invasion, and poor tumor differentiation. In multivariate analysis, a low AGR (hazard ratio [95% confidence interval]) (2.394 [1.092-5.213]; p = 0.030) and microvascular invasion (2.268 [1.019-5.169]; p = 0.045) were independent predictors of OS. DISCUSSION/CONCLUSION A low AGR was significantly associated with poor OS in patients with HCC, regardless of liver etiology. This may assist in treatment stratification and better management of patients with HCC.
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Affiliation(s)
- Masashi Utsumi
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Koji Kitada
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Naoyuki Tokunaga
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Toru Narusaka
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Ryosuke Hamano
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Hideaki Miyasou
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Yousuke Tsunemitsu
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Shinya Otsuka
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Masaru Inagaki
- Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
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Liu H, Qiu G, Hu F, Wu H. Fibrinogen/albumin ratio index is an independent predictor of recurrence-free survival in patients with intrahepatic cholangiocarcinoma following surgical resection. World J Surg Oncol 2021; 19:218. [PMID: 34284775 PMCID: PMC8293519 DOI: 10.1186/s12957-021-02330-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/08/2021] [Indexed: 02/08/2023] Open
Abstract
Background Systemic inflammation and nutritional status are associated with tumor development and progression. This study investigated the prognostic value of fibrinogen/albumin ratio index (FARI) in predicting recurrence-free survival (RFS) in patients with intrahepatic cholangiocarcinoma (ICC) undergoing hepatectomy. Methods A retrospective cohort was conducted including patients who received curative hepatectomy for ICC at our hospital between May 2010 and December 2016. We collected the preoperative hematologic parameters and clinical data of all patients. Time-dependent receiver operating characteristic curve was used to identify the optimal cutoff value of FARI. The association between FARI-high and FARI-low group was investigated by using the Kaplan–Meier method. A nomogram based on the results of univariate and multivariate analysis was established. Results A total of 394 patients with ICC who underwent hepatectomy at our hospital were enrolled. K-M analysis revealed that increased FARI was related to reduced RFS (P < 0.001). The multivariate analysis indicated that tumor number, tumor–node–metastasis stage, lymph node metastasis, cirrhosis, serum carbohydrate antigen 19-9, and FARI were independent predictors of RFS, and the ROC curve analysis showed that the optimal cutoff value for FARI was 0.084 based on the Youden index. The nomogram for FARI showed satisfactory accuracy in predicting RFS for ICC patients undergoing hepatectomy (C index = 0.663; AIC = 3081.07). Conclusion Preoperative FARI is an independent predictor of RFS in patients undergoing hepatectomy for ICC, and the nomogram can be useful for clinical decision-making in the postoperative management of these patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-021-02330-2.
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Affiliation(s)
- Hu Liu
- Department of Liver Surgery, Liver Transplantation Division, West China Hospital, Sichuan University, Chengdu, 610041, China.,Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Guoteng Qiu
- Department of Liver Surgery, Liver Transplantation Division, West China Hospital, Sichuan University, Chengdu, 610041, China.,Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Fengjuan Hu
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hong Wu
- Department of Liver Surgery, Liver Transplantation Division, West China Hospital, Sichuan University, Chengdu, 610041, China. .,Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
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26
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Usefulness of albumin-globulin ratio as a clinical prognostic factor in patients with thyroid cancer treated with radioiodine. Ann Nucl Med 2021; 35:1015-1021. [PMID: 34061291 DOI: 10.1007/s12149-021-01635-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Albumin-globulin ratio (AGR), which is calculated by dividing serum albumin by serum globulin, is considered as a cancer-related inflammation biomarker. Although the prognosis of many solid cancers has been shown to be associated with AGR, there are no studies to demonstrate the association between the prognosis of thyroid cancer and AGR. The purpose of this study is to reveal the relationship between AGR and overall survival (OS) in patients with thyroid cancer who received radioactive iodine therapy (RIT). METHODS Eighty-eight patients with thyroid cancer who had received RIT for the first time in our institution were included. The values before RIT were adopted as initial measurements for serum albumin, globulin, and thyroglobulin (Tg) and used for analysis. Patients were divided into two groups based on the AGR value. We analyzed the relationship between clinical factors and treatment outcome. RESULTS The median follow-up period was 92.4 months (range: 30.1-173.9 months). The 5-year OS and progression-free survival (PFS) were 94% and 54%, respectively. Seventeen patients (< 65 years, 8; and ≥ 65 years, 9) died during the follow-up period. Low AGR was significantly associated with OS in both univariate and multivariate analyses (p = 0.0059 and p = 0.0120, respectively). As the 5-year OS was as high as 94%, there was no significant difference in survival rate between the two groups during the first 5 years. However, there seemed to be a remarkable difference in 10 years after the first RIT. On the other hand, Tg was significantly associated with PFS in both univariate and multivariate analyses (p = 0.0016 and p = 0.0441, respectively). In patients under the age of 65, the PFS rate was significantly lower in the low AGR group (p < 0.0001), while there was no difference in PFS rate between the two AGR groups in patients aged 65 years or older. CONCLUSIONS AGR may be used as a prognostic factor in relatively younger patients with thyroid cancer treated with radioiodine, while it may be less useful in the older. Overall, it may be an independent prognostic factor for long-term survival in those with thyroid cancer.
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Shinde R, Bhandare MS, Chaudhari V, Sarodaya V, Agarwal V, Shrikhande S. Preoperative Albumin-Globulin Ratio and Its Association with Perioperative and Long-Term Outcomes in Patients Undergoing Pancreatoduodenectomy. Dig Surg 2021; 38:275-282. [PMID: 34038911 DOI: 10.1159/000516278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 03/29/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Systemic inflammatory response is involved in natural progression of cancers by different pathways. Albumin-globulin ratio (AGR) has been reported to have impact on prognosis in various solid tumors. OBJECTIVE To study the significance of AGR on perioperative and long-term outcomes in patients undergoing PD. METHODS This is a post hoc analysis of the pancreatic surgery database from January 2012 to March 2017. Cutoff value for AGR was calculated by using the receiver operating curve, and the study cohort was divided into group I (AGR ≥1) and group II (AGR <1). Two groups were compared for perioperative and long-term survival outcomes. RESULTS Two groups were comparable with respect to clinicodemographic variables. Groups I and II had similar perioperative outcomes (p > 0.05) like median hospital stay (14 vs. 15 days), clinically relevant postoperative pancreatic fistula (16.6 vs. 15.7%), hemorrhage (3.1 vs. 2.6%), bile leak (1.4 vs. 0.65%), overall morbidity (30.1 vs. 28.9%), and postoperative mortality (2.7 vs. 3.9%). With a median follow-up of 3 years, median survival, overall survival, and disease-free survival were similar in both groups. CONCLUSION AGR at the cutoff value of ≥1 was not associated with adverse perioperative and long-term oncological outcomes after PD.
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Affiliation(s)
- Rajesh Shinde
- Department of Surgical Oncology, GI & HPB Service, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Manish Suresh Bhandare
- Department of Surgical Oncology, GI & HPB Service, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Vikram Chaudhari
- Department of Surgical Oncology, GI & HPB Service, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Varun Sarodaya
- Department of Surgical Oncology, GI & HPB Service, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Vandana Agarwal
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Shailesh Shrikhande
- Department of Surgical Oncology, GI & HPB Service, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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Jin H, Wang H, Li G, Hou Q, Wu W, Liu F. Risk factors for early postoperative recurrence in single and small hepatitis B virus-associated primary hepatocellular carcinoma. J Int Med Res 2021; 48:300060520961260. [PMID: 33044114 PMCID: PMC7556173 DOI: 10.1177/0300060520961260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the risk factors of early postoperative recurrence in patients with single and small (≤3 cm) hepatitis B virus-associated primary hepatocellular carcinoma (HBV-HCC). Methods This retrospective study analyzed patients with single and small HBV-HCC. All patients were followed up for 1 year after surgery. Results Among 182 patients, 54 patients had early recurrence within 1 year. The recurrence group had higher proportions of men, drinking history, Child–Turcotte–Pugh (CTP) class C, patients who underwent transarterial chemoembolization (TACE), and serum alpha-fetoprotein (AFP) >10 ng/mL as well as higher gamma-glutamyl transpeptidase (GGT) levels and lower total protein (TP) and CD8+ T lymphocyte levels than the no recurrence group. Cox multivariate regression analysis demonstrated that drinking history (HR, 1.312; 95% CI, 1.042–1.652), CTP class C (HR, 1.236; 95% CI, 1.037–1.473), TACE treatment (HR, 1.241; 95% CI, 1.026–1.501), GGT (HR, 1.138; 95% CI, 1.042–1.243), TP (HR, 0.729; 95% CI, 0.555–0.957), and AFP (HR, 2.519; 95% CI, 1.343–4.726) were independently associated with early postoperative recurrence. Conclusion Drinking history, CTP class C, TACE, serum AFP, GGT, and TP levels were independently associated with early postoperative recurrence in patients with single and small HBV-HCC.
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Affiliation(s)
- Hongmei Jin
- Department of Hepatology, Qingdao No. 6 People's Hospital, Qingdao, Shandong, China
| | - Hui Wang
- Department of Hepatology, Qingdao No. 6 People's Hospital, Qingdao, Shandong, China
| | - Guanghao Li
- Department of Hepatobiliary surgery, Qingdao No. 6 People's Hospital, Qingdao, Shandong, China
| | - Qingshun Hou
- Department of Hepatology, Qingdao No. 6 People's Hospital, Qingdao, Shandong, China
| | - Wei Wu
- Department of Hepatology, Qingdao No. 6 People's Hospital, Qingdao, Shandong, China
| | - Fuhui Liu
- Department of Hepatology, Qingdao No. 6 People's Hospital, Qingdao, Shandong, China
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Gemcioglu E, Davutoglu M, Catalbas R, Karabuga B, Kaptan E, Aypak A, Kalem AK, Özdemir M, Yeşilova NY, Kalkan EA, Civak M, Kücüksahin O, Erden A, Ates I. Predictive values of biochemical markers as early indicators for severe COVID-19 cases in admission. Future Virol 2021. [PMCID: PMC8114836 DOI: 10.2217/fvl-2020-0319] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aim: COVID-19 is a pandemic that causes high morbidity and mortality, especially in severe patients. In this study, we aimed to search and explain the relationship between biochemical markers, which are more common, easily available and applicable to diagnose and to stage the disease. Materials & methods: In this study, 609 patients were evaluated retrospectively. 11 biochemical parameters were included in analysis to explain the relationship with severity of disease. Results: Nearly, all the parameters that have been evaluated in this study were statistically valuable as a predictive parameter for severe disease. Areas under the curve of blood urea nitrogen (BUN)/albumin ratio (BAR), CALL score and lymphocyte/C-reactive protein ratio were 0.795, 0.778 and 0.770. The BAR and neutrophil/albumin ratios provide important prognostic information for decision-making in severe patients with COVID-19. Conclusion: High BAR and neutrophil/albumin ratios may be a better predictor of severity COVID-19 than other routinely used parameters in admission.
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Affiliation(s)
- Emin Gemcioglu
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Mehmet Davutoglu
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Ramis Catalbas
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Berkan Karabuga
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Enes Kaptan
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Adalet Aypak
- Ankara City Hospital, Department of Infectious Diseases & Clinical Microbiology, Ankara 06800, Turkey
| | - Ayse K Kalem
- Yıldırım Beyazıt University School of Medicine, Department of Infectious Diseases & Clinical Microbiology, Ankara 06800, Turkey
| | - Mustafa Özdemir
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Necati Y Yeşilova
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Emra A Kalkan
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Musa Civak
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Orhan Kücüksahin
- Yıldırım Beyazıt University School of Medicine, Department of Rheumatology, Ankara 06800, Turkey
| | - Abdulsamet Erden
- Ankara City Hospital, Department of Rheumatology, Ankara 06800, Turkey
| | - Ihsan Ates
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
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30
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Aktepe OH, Güner G, Güven DC, Taban H, Yıldırım HÇ, Şahin TK, Ardıç FS, Yeter HH, Yüce D, Erman M. Impact of albumin to globulin ratio on survival outcomes of patients with metastatic renal cell carcinoma. Turk J Urol 2021; 47:113-119. [PMID: 33819441 DOI: 10.5152/tud.2021.20377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/14/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The albumin to globulin ratio (AGR) has been demonstrated to be associated with survival outcomes in various tumor types. However, the prognostic value of AGR in patients with metastatic renal carcinoma (mRCC) remains unclear. Therefore, this study aimed to investigate the impact of AGR values in predicting overall survival (OS) of patients with mRCC treated with targeted therapy. MATERIAL AND METHODS A total of 163 patients with mRCC treated with targeted therapy between 2008 and 2019 were enrolled. The AGR value was measured as AGR: albumin/(total protein-albumin). The Kaplan-Meier method with long-rank testing and Cox proportional hazard models were used to estimate the correlation of AGR with OS. RESULTS The receiver operating characteristic curve analysis showed that the optimal cut-off value of AGR in predicting OS was 1.11 with a sensitivity of 37.25% and specificity of 85.25% (area under curve, 0.62; 95% confidence interval [CI], 0.54-0.69; p=0.005). OS was significantly higher in patients with AGR>1.11 than in those with AGR≤1.11 (36.2 vs. 12.4 months; p<0.001). After adjustment for the number of covariates, multivariate Cox regression analysis identified a high AGR as an independent indicator of better OS (hazard ratio, 0.476; 95% CI, 0.304-0.745; p=0.001). CONCLUSION Our results suggested that AGR value, which is an easily obtainable and cost-effective marker in routine biochemistry testing, could function as an independent predictor of OS in patients with mRCC treated with targeted therapy.
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Affiliation(s)
| | - Gürkan Güner
- Hacettepe University Cancer Institute, Ankara, Turkey
| | | | - Hakan Taban
- Hacettepe University Cancer Institute, Ankara, Turkey
| | | | - Taha Koray Şahin
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fadime Sinem Ardıç
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hacı Hasan Yeter
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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31
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Zhang CC, Zhang CW, Xing H, Wang Y, Liang L, Diao YK, Chen TH, Lau WY, Bie P, Chen ZY, Yang T. Preoperative Inversed Albumin-to-Globulin Ratio Predicts Worse Oncologic Prognosis Following Curative Hepatectomy for Hepatocellular Carcinoma. Cancer Manag Res 2020; 12:9929-9939. [PMID: 33116850 PMCID: PMC7567562 DOI: 10.2147/cmar.s275307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/16/2020] [Indexed: 01/27/2023] Open
Abstract
Background A normal albumin-to-globulin ratio (NAGR) in serum is greater than 1. Inversed albumin-to-globulin ratio (IAGR < 1) indicates poor synthetic liver function or malnutrition. The aim of this study is to evaluate whether preoperative IAGR was associated with worse oncologic survival after hepatectomy for hepatocellular carcinoma (HCC). Patients and Methods Patients who underwent curative hepatectomy for HCC between 2009 and 2016 in four centers were divided into the IAGR and NAGR groups based on their preoperative levels, and their clinical characteristics and long-term survival outcomes were compared. Univariable and multivariable Cox regression analyses were performed to identify risk factors of overall survival (OS) and recurrence-free survival (RFS). Results Of 693 enrolled patients, 136 (19.6%) were in the IAGR group. Their 5-year OS and RFS rates were 31.6% and 21.3%, respectively, which were significantly worse than the NAGR group (43.4% and 28.7%, both P < 0.001). The area under the receiver operating characteristic curves in predicting 5-year OS and RFS using the albumin-to-globulin ratio were 0.68 and 0.67, respectively, which were significantly higher than albumin (0.60 and 0.59), globulin (0.56 and 0.57), Child-Pugh grading (0.61 and 0.60), Model for End-Stage Liver Disease Score (0.59 and 0.58), and Albumin-Bilirubin grading (0.64 and 0.63). Multivariable analyses identified that preoperative IAGR was independently associated with worse OS (HR: 1.444, 95% confidence interval (CI): 1.125–1.854, P = 0.004) and RFS (HR: 1.463, 95% CI: 1.159–1.848, P = 0.001). Conclusion Preoperative IAGR was useful in predicting worse OS and RFS in patients who underwent curative hepatectomy for HCC.
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Affiliation(s)
- Cheng-Cheng Zhang
- Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Cheng-Wu Zhang
- Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China
| | - Hao Xing
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China
| | - Yu Wang
- Department of Hepatobiliary Surgery, Chongqing University Cancer Hospital, Chongqing, China
| | - Lei Liang
- Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China.,Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, China
| | - Yong-Kang Diao
- Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China.,Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, China
| | - Ting-Hao Chen
- Department of General Surgery, Ziyang First People's Hospital, Sichuan, China
| | - Wan Yee Lau
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China.,Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Ping Bie
- Department of Hepatobiliary, The Third Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Zhi-Yu Chen
- Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tian Yang
- Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China
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Wang YT, Fang KH, Hsu CM, Chang GH, Lai CH, Lee YC, Tsai MS, Huang EI, Tsai YT. Retrospective study on the potential of albumin/globulin ratio as a prognostic biomarker for oral cavity cancer patients. Eur Arch Otorhinolaryngol 2020; 278:227-238. [DOI: 10.1007/s00405-020-06145-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023]
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33
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Yalikun K, Tuersun T, Abudula M, Tiheiran M, Fu Q, Yisireyili D, Zhou Q. Serum albumin levels and serum albumin-globulin ratio are associated with poor prognosis in glioblastoma. Transl Cancer Res 2020; 9:1594-1603. [PMID: 35117507 PMCID: PMC8798444 DOI: 10.21037/tcr.2020.01.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/03/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Serum albumin levels (ALB) and albumin-globulin ratio (AGR) are reliable and convenient markers of the nutritional status and inflammation of human body, and ALB has been identified as a prognostic factor in the patients of glioblastoma (GBM). However, no literature has reported the prediction value of AGR for GBM. METHODS In this study we evaluate the serum ALB and AGR levels for GBM. A total of 126 patients with GBM who underwent surgical resection in our institution between 2013 and 2017 were analyzed retrospectively. Clinical information was obtained from electronic medical records. Multiple logistic regression and Cox proportional hazards models were used to assess the prediction value of preoperative ALB and AGR for GBM. RESULTS Preoperative ALB (HR 0.342, 95% CI, 0.123-0.954, P=0.040) and postoperative adjuvant therapy (HR 0.042, 95% CI, 0.005-0.330, P=0.003) were significantly related to progression-free survival (PFS). Cox regression analysis showed the significance of adjuvant therapy (HR 3.579, 95% CI, 2.236-5.729, P<0.001). Preoperative AGR (HR 0.280, 95% CI, 0.103-0.763, P=0.013) and adjuvant therapy (HR 0.156, 95% CI, 0.047-0.513, P=0.002) were showed significance, and Cox regression analysis showed preoperative AGR (HR 1.810, 95% CI, 1.095-2.992, P=0.021) and adjuvant therapy (HR 4.702, 95% CI, 2.841-7.782, P<0.001) were independent predictors of overall survival (OS). CONCLUSIONS The ALB and AGR had significant predictive values for the prognosis of GBM; postoperative adjuvant treatment is also an independent predictor for the prognosis of GBM patients.
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Affiliation(s)
- Kugeluke Yalikun
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Tuerhong Tuersun
- Department of Intensive Care Unit, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Maiaitituersun Abudula
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Maijudan Tiheiran
- Department of Imaging, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Qiang Fu
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Dilimulati Yisireyili
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Qingjiu Zhou
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
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Peng F, Sun L, Chen T, Zhu Y, Zhou W, Li P, Chen Y, Zhuang Y, Huang Q, Long H. Albumin-globulin ratio and mortality in patients on peritoneal dialysis: a retrospective study. BMC Nephrol 2020; 21:51. [PMID: 32059708 PMCID: PMC7023751 DOI: 10.1186/s12882-020-1707-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/28/2020] [Indexed: 01/14/2023] Open
Abstract
Background Albumin-globulin ratio (AGR), a variable based on serum albumin and non-albumin proteins, has been demonstrated as a predictor of mortality in patients with malignant neoplasm. The aim of this study was to evaluate the prognostic value of AGR on peritoneal dialysis (PD) patients. Methods We retrospectively analyzed 602 incident PD patients from January 1st, 2008, to December 31st, 2017, at our center and followed them until December 31st, 2018. Kaplan-Meier curves and multivariate Cox regression models were applied to analyze the association between AGR and all-cause of mortality and cardiovascular mortality. Results The median follow-up time was 32.17 (interquartile range = 32.80) months. During follow-up, 131 (21.8%) patients died, including 57 patients (43.5%) who died due to cardiovascular diseases. Kaplan-Meier curves showed that patients with AGR > 1.26 had better rates of survival than those with AGR ≤ 1.25 (p < 0.001). After adjusting for potential confounders, the lower AGR level was significantly associated with an increased all-cause and cardiovascular mortality [hazard ratio (HR): 1.57, 95% confidence interval (CI): 1.07–2.32, p = 0.022 and HR: 2.01, 95% CI: 1.10–3.69, p = 0.023 respectively]. Conclusions Patients with a low AGR level had an increased all-cause and cardiovascular mortality. AGR may be a useful index in identifying patients on PD at risk for CVD and all-cause of mortality.
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Affiliation(s)
- Fenfen Peng
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Lingzhi Sun
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Ting Chen
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yan Zhu
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Weidong Zhou
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Peilin Li
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yihua Chen
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yiyi Zhuang
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Qianyin Huang
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China.
| | - Haibo Long
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China.
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35
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Zhang Y, Zhu JY, Zhou LN, Tang M, Chen MB, Tao M. Predicting the Prognosis of Gastric Cancer by Albumin/Globulin Ratio and the Prognostic Nutritional Index. Nutr Cancer 2019; 72:635-644. [PMID: 31423840 DOI: 10.1080/01635581.2019.1651347] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Yan Zhang
- Department of Oncology, the first Affiliated Hospital of Soochow University, Jiangsu, China
- Department of Oncology, Affiliated Kunshan Hospital of Jiangsu University, Jiangsu, China
| | - Jia-Yao Zhu
- Department of Oncology, Affiliated Kunshan Hospital of Jiangsu University, Jiangsu, China
| | - Li-Na Zhou
- Department of Oncology, Affiliated Kunshan Hospital of Jiangsu University, Jiangsu, China
| | - Min Tang
- Department of Oncology, Affiliated Kunshan Hospital of Jiangsu University, Jiangsu, China
| | - Min-Bin Chen
- Department of Oncology, Affiliated Kunshan Hospital of Jiangsu University, Jiangsu, China
| | - Min Tao
- Department of Oncology, the first Affiliated Hospital of Soochow University, Jiangsu, China
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Xu Y, Xu X, Xi C, Ye N, Wang Y. Prognostic value of preoperative albumin to globulin ratio in elderly patients with rectal cancer. Medicine (Baltimore) 2019; 98:e16066. [PMID: 31192969 PMCID: PMC6587531 DOI: 10.1097/md.0000000000016066] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
To identify the value of predictors of poor prognosis of elderly patients with rectal cancer who underwent surgery, we investigated the relations between albumin to globulin ratio (AGR) and clinicopathological findings.We conducted a retrospective cohort study of clinicopathological characteristics (general status, pathological features of tumors, preoperative laboratory data, disease free, and overall survival) for elderly patients with stage I-III rectal cancer. The AGR is calculated as albumin/(total protein - albumin).According to the optimal cut-off point of AGR (1.43), the enrolled patients were divided into low AGR (n = 83) and high AGR (n = 136) groups. Meanwhile, age, hemoglobin, tumor size, and differentiation degree were the independent risk factors of low preoperative AGR value. Compared to patients with high AGR, those with low AGR were related to worse disease-free survival (DFS) (P = .0008) and overall survival (OS) (P = .0003). Moreover, in multivariate analysis, low AGR and poor TNM stage were the independent predictor of poor DFS and OS. Finally, the nomograms illustrated the effect of prognostic factors on DFS and OS.Preoperative AGR has a significant prognostic value and was identified as an independent predictor of DFS and OS in elderly rectal cancer patients.
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He LL, Liu XL, Zhang S, Li MG, Wang XB, Jiang YY, Yang ZY. Independent risk factors for disease recurrence after surgery in patients with hepatitis B virus-related hepatocellular carcinoma ≤3 cm in diameter. Gastroenterol Rep (Oxf) 2019; 7:250-257. [PMID: 31413831 PMCID: PMC6688729 DOI: 10.1093/gastro/goz009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/30/2018] [Accepted: 02/21/2019] [Indexed: 12/14/2022] Open
Abstract
Background Post-operative recurrence rates are high for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). This study aimed to explore the factors associated with post-operative 1-year recurrence rate in patients with HBV-related HCC who had a single small primary tumor (≤3 cm in diameter). Methods This was a retrospective study of 203 (training cohort) and 64 (validation cohort) patients newly diagnosed with HBV-related HCC who had a single small primary tumor. The first year of post-operative follow-up was examined. Factors potentially associated with HCC recurrence were identified using Cox regression analyses. A model was constructed based on the factors identified and the prognostic value of the model was evaluated using receiver operating characteristic (ROC) curve analysis and calculation of the area under the ROC curve (AUC). Results A history of alcoholism and serum levels of α-fetoprotein, total protein and γ-glutamyl transpeptidase (GGT) were independently associated with 1-year recurrence rate after surgery. A predictive model based on these four factors had an AUC of 0.711 (95% confidence interval, 0.643-0.772) in the training cohort and 0.727 (95% confidence interval, 0.601-0.831) in the validation cohort. The 1-year recurrence rate was significantly lower in the low-risk group than in the high-risk group in both the training cohort (17.0% vs. 49.5%, P < 0.001) and the validation cohort (43.2% vs. 74.1%, P = 0.031). Conclusion A history of alcoholism and serum levels of α-fetoprotein, total protein and γ-glutamyl transpeptidase were independently associated with post-operative 1-year recurrence rate in patients with HBV-related HCC who had a single small primary tumor (≤3 cm in diameter).
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Affiliation(s)
- Ling-Ling He
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Xiao-Li Liu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Shuan Zhang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Meng-Ge Li
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Xian-Bo Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Yu-Yong Jiang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Zhi-Yun Yang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
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Yang A, Xiao W, Chen D, Wei X, Huang S, Lin Y, Zhang C, Lin J, Deng F, Wu C, He X. The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients. Cancer Med 2018; 7:6040-6050. [PMID: 30430769 PMCID: PMC6308097 DOI: 10.1002/cam4.1873] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/30/2018] [Accepted: 10/22/2018] [Indexed: 12/17/2022] Open
Abstract
Background Vascular invasion, rather than tumor size, was applied into the 7th edition of the AJCC TNM staging system to predict survival of solitary hepatocellular carcinoma (HCC) patients. However, does this mean tumor size is of little value in prognostic prediction? The current study was designed to explore the prognostic ability of tumor sizes in solitary HCC. Methods A total of 18 591 patients with solitary HCC categorized as T1 and T2 were retrieved from the Surveillance Epidemiology and End Results (SEER) database. The Cox proportional hazards regression model was adopted to evaluate the impact of tumor sizes on overall survival (OS) and disease‐specific survival (DSS) in general and in subgroups stratified by vascular invasion and surgery type. Results Large tumor sizes (>39 mm) were associated with unfavorable clinicopathologic characteristics. Compared with tumors ≤30 mm, tumors between 31‐50 mm and tumors >50 mm showed significantly worse OS and DSS in general using multivariate analysis (all P < 0.001). In subgroup analyses, for patients without vascular invasion, tumor size was a notable prognostic indicator for OS in the radiofrequency ablation group (P < 0.001), rather than in the liver resection or transplantation group. Nevertheless, for patients with vascular invasion, tumor sizes exhibited a notable impact on OS in the liver resection and transplantation group. Conclusions The AJCC TNM staging system for solitary HCC would be more comprehensive if tumor sizes were integrated into the T2 classification. Additionally, for T1 patients, tumor sizes play no role in the choice between resection and transplantation.
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Affiliation(s)
- Anli Yang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weikai Xiao
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Dong Chen
- Department of Pancreatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaoli Wei
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Shanzhou Huang
- Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ye Lin
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chuanzhao Zhang
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jianwei Lin
- Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Feiwen Deng
- Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chenglin Wu
- Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaoshun He
- Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Zhang Y, Wang L, Lin S, Wang R. Preoperative albumin-to-globulin ratio as a significant prognostic indicator in urologic cancers: a meta-analysis. Cancer Manag Res 2018; 10:4695-4708. [PMID: 30410403 PMCID: PMC6199965 DOI: 10.2147/cmar.s178271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Emerging studies reported that preoperative albumin-to-globulin ratio (AGR) correlated with tumor progression and prognosis in several types of cancer. The aim of this study was to systematically explore the association between preoperative AGR and clinical outcomes in cancers of the urinary system. Methods Relevant articles were searched in PubMed, Embase and Web of Science by two independent investigators from inception to June 1, 2018. Eligible studies were selected based on predetermined selection criteria. Summarized HRs or ORs and 95% CIs were calculated for prognosis and clinicopathologic features with the fixed-effects or random-effects models. Results Eight cohort studies comprising 2,668 patients were included for analysis. The pooled results showed that a low AGR significantly correlated with poor OS (HR: 0.38, 95% CI: 0.27-0.48, P<0.001), worse cancer-specific survival (CSS) (HR: 0.36, 95% CI: 0.22-0.50, P<0.001) and inferior event-free survival (EFS) (HR: 0.36, 95% CI: 0.25-0.48, P<0.001) in urologic cancers. In addition, patients in low and high AGR groups showed significant differences in lymphovascular invasion (P<0.001), pT status (P<0.001) and pN status (P<0.001). Conclusion Preoperative AGR might be a valuable, cheap and reproducible prognostic bio-marker in urologic cancers following surgical resection.
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Affiliation(s)
- Yi Zhang
- Department of General Surgery, The First People's Hospital of Neijiang, Neijiang 641000, Sichuan Province, China,
| | - Lijuan Wang
- Department of Nephrology, Shangrao People's Hospital, Shangrao 334000, Jiangxi Province, China
| | - Shibu Lin
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hainan Medical College, Haikou 570102, Hainan Province, China
| | - Rong Wang
- Department of General Surgery, The First People's Hospital of Neijiang, Neijiang 641000, Sichuan Province, China,
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Man Z, Pang Q, Zhou L, Wang Y, Hu X, Yang S, Jin H, Liu H. Prognostic significance of preoperative prognostic nutritional index in hepatocellular carcinoma: a meta-analysis. HPB (Oxford) 2018; 20:888-895. [PMID: 29853431 DOI: 10.1016/j.hpb.2018.03.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/20/2018] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND To date, epidemiological evidence of the association between preoperative prognostic nutritional index (PNI) and the prognosis of hepatocellular carcinoma (HCC) remains controversial. METHODS A literature search was performed in the databases of PubMed, Embase, and Web of Science. Hazard ratio (HR), odds ratio (OR), and 95% confidence interval (CI) were extracted to estimate the association of preoperative PNI with overall survival (OS), disease-free survival (DFS), and postoperative recurrence of HCC, respectively. A random-effects model was used to calculate the pooled effect size. RESULTS Thirteen studies with a total of 3,738 patients with HCC met inclusion criteria for this meta-analysis. It indicated that a lower level of preoperative PNI was a significant predictor of worse OS (HR = 1.82, 95%CI: 1.44-2.31) and DFS (HR = 1.49, 95% CI: 1.06-2.07). In addition, risk of postoperative recurrence was significantly higher in patients with a lower preoperative PNI (OR = 1.92, 95% CI: 1.33-2.76). Subgroup analysis based on therapeutic intent demonstrated a significant positive association between preoperative low PNI and worse OS for those patients undergoing surgical resection and for those undergoing TACE or non-surgical treatment. CONCLUSION The current meta-analysis demonstrates that preoperative PNI is a prognostic marker in HCC.
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Affiliation(s)
- Zhongran Man
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China
| | - Qing Pang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China.
| | - Lei Zhou
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China
| | - Yong Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China
| | - Xiaosi Hu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China
| | - Song Yang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China
| | - Hao Jin
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China.
| | - Huichun Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China.
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Geriatric nutritional risk index predicts prognosis after hepatectomy in elderly patients with hepatitis B virus-related hepatocellular carcinoma. Sci Rep 2018; 8:12561. [PMID: 30135506 PMCID: PMC6105611 DOI: 10.1038/s41598-018-30906-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/06/2018] [Indexed: 02/08/2023] Open
Abstract
Geriatric nutritional risk index (GNRI) is a novel and useful screening tool for evaluating nutritional status in elderly in-patients. We aimed to investigate whether the preoperative GNRI could be a predictive factor for outcomes in patients over 65 years of age with a diagnosis of hepatocellular carcinoma (HCC). We retrospectively enrolled 261 consecutive HCC patients after hepatectomy and classified them into four risk groups based on the GNRI values: high risk (GNRI, <82), moderate risk (GNRI, 82–92), low risk (GNRI, 92–98), and normal (GNRI, >98). We found that the lower GNRI value was significantly associated with severe postoperative complications (P < 0.001) and liver failure (P < 0.001). By multivariate logistic regression analysis, high risk- and moderate risk GNRI groups were identified as independent risk factors for postoperative serve complications and liver failure. Multivariate Cox regression analysis revealed preoperative GNRI (P < 0.001) adversely affected overall survival. In conclusion, preoperative GNRI could predict severe postoperative complications included liver failure, and the lower GNRI value was associated with worse overall survival after hepatectomy in elderly HCC patients.
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Qin J, Qin Y, Wu Y, Wei A, Luo M, Liao L, Lin F. Application of albumin/globulin ratio in elderly patients with acute exacerbation of chronic obstructive pulmonary disease. J Thorac Dis 2018; 10:4923-4930. [PMID: 30233866 DOI: 10.21037/jtd.2018.07.47] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has become an important disease of hospitalized elderly patients, which lack simple and inexpensive indicators for evaluating the condition and prognosis. This study was performed to investigate the clinical significance of the serum albumin/globulin ratio (AGR) in elderly patients with AECOPD. Methods The data of 252 hospitalized elderly patients with AECOPD, 89 stable COPD patients and 115 elderly healthy individuals were analyzed and compared. The differences in the AGR, logarithm of the serum C-reactive protein (LogCRP) level, prealbumin (PA) level, and immunoglobulin G (IgG) level were compared. AECOPD patients were grouped using the optimal cutoff values of each index to compare the difference in the combined infection rate. The correlation between hospital stays and AGR was analyzed. Results The AGR, LogCRP, PA level, and IgG level were different among the AECOPD group, stable COPD group and healthy control groups (P<0.05). The AGR, LogCRP, and PA level were different (P<0.05) among the Global Initiative for Chronic Obstructive Lung Disease (GOLD) I, II, II, and IV groups. Age, AGR, LogCRP, and PA level were different (P<0.05) between the infection and non-infection groups. After grouping according to the optimal cutoff values, the combined infection rate was different (P<0.05). The AGR was negatively correlated with the hospital stay (r=-0.583, P<0.001). The hospital stay was longer in patients with an AGR of <1.37 than ≥1.37 (P<0.001). Conclusions The AGR can be regarded as a reference index for evaluating the condition of elderly patients with AECOPD, determining the presence of combined infection, and predicting the prognosis.
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Affiliation(s)
- Jinqiu Qin
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Yuanyuan Qin
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Yangyang Wu
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Aiqiu Wei
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Meiling Luo
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Lin Liao
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Faquan Lin
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
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Bala S, Chugh NA, Bansal SC, Garg ML, Koul A. Radiomodulatory effects of Aloe vera on hepatic and renal tissues of X-ray irradiated mice. Mutat Res 2018; 811:1-15. [PMID: 30014950 DOI: 10.1016/j.mrfmmm.2018.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 01/14/2023]
Abstract
The present study was aimed to explore the protective role of Aloe vera gel extract against hepatic and renal damage caused by X-ray exposure to mice. Male balb/c mice were divided into four groups: control, Aloe vera gel extract [AV] (50 mg/ kg b.w on alternate days for 30 days), X-ray (2 Gy) and AV + X-ray. X-ray irradiation enhanced the serum levels of liver function indices and chromosomal abnormalities in liver. Kidney function markers were found to be deranged and were accompanied by reduced glomerular filtration rate indicating renal dysfunction. Irradiation caused histopathological and biochemical alterations in both tissues which was associated with enhanced reactive oxygen species (ROS), lipid peroxidation (LPO) levels, lactate dehydrogenase (LDH) activity and enhanced apoptosis as revealed by TUNEL assay and DNA fragmentation. The administration of Aloe vera gel extract to X-ray exposed animals significantly improved their hepatic and renal function parameters which were associated with a reduction in ROS/LPO levels, LDH activity and chromosomal abnormalities as compared to their irradiated counterparts. In vitro assays revealed effective radical scavenging ability of Aloe vera gel extract, which may be linked to its potential in exhibiting antioxidant effects in in vivo conditions. This data suggested that Aloe vera may serve to boost the antioxidant system, thus providing protection against hepatic and renal damage caused by X-ray.
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Affiliation(s)
- Shashi Bala
- Department of Biophysics, Panjab University, Chandigarh, 160014, India.
| | - Neha Arora Chugh
- Department of Biophysics, Panjab University, Chandigarh, 160014, India.
| | | | - Mohan Lal Garg
- Department of Biophysics, Panjab University, Chandigarh, 160014, India.
| | - Ashwani Koul
- Department of Biophysics, Panjab University, Chandigarh, 160014, India.
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Chen WZ, Yu ST, Xie R, Lv YX, Xu DB, Yu JC. Preoperative albumin/globulin ratio has predictive value for patients with laryngeal squamous cell carcinoma. Oncotarget 2018; 8:48240-48247. [PMID: 28654895 PMCID: PMC5564641 DOI: 10.18632/oncotarget.18443] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/29/2017] [Indexed: 01/08/2023] Open
Abstract
This study evaluated the predictive value of the preoperative albumin/globulin ratio (AGR) in laryngeal squamous cell carcinoma (LSCC) retrospectively, which has not been reported before. The current study enrolled 241 newly diagnosed LSCC patients in the Second Affiliated Hospital of Nanchang University between January 2005 and December 2010. The optimal AGR cut-off value for overall survival (OS) was determined to be 1.28. Univariate survival analysis identified sex, low AGR, T classification, histological grade and nodal metastasis as factors associated with poor OS. Additionally, a low AGR, T classification, nodal metastasis, and histological grade were associated with poor disease-free survival (DFS) in LSCC patients. In multivariate survival analysis, nodal metastasis and a low AGR remained significant for OS and DFS. Our preliminary study revealed that low preoperative AGR could serve as a valuable and easily-assessed blood-based indicator to predict the prognosis of LSCC patients.
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Affiliation(s)
- Wan-Zhi Chen
- Department of Thyroid and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Shi-Tong Yu
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rong Xie
- Department of Thyroid and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yun-Xia Lv
- Department of Thyroid and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - De-Bin Xu
- Department of Thyroid and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ji-Chun Yu
- Department of Thyroid and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Li R, Zhang M, Wang Y, Yung KKL, Su R, Li Z, Zhao L, Dong C, Cai Z. Effects of sub-chronic exposure to atmospheric PM 2.5 on fibrosis, inflammation, endoplasmic reticulum stress and apoptosis in the livers of rats. Toxicol Res (Camb) 2018; 7:271-282. [PMID: 30090581 PMCID: PMC6062260 DOI: 10.1039/c7tx00262a] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/02/2018] [Indexed: 01/01/2023] Open
Abstract
Epidemiological studies have revealed that exposure to PM2.5 is linked to liver cancer. However, the hepatic toxicity and relevant molecular mechanisms of PM2.5 have not yet been fully described. Herein, we report on our investigation of the fibrosis, inflammation, endoplasmic reticulum (ER) stress and apoptosis in the livers of rats, caused by exposure to PM2.5 during summer and winter in Taiyuan, China. Male SD rats were sub-chronically exposed to PM2.5 (in summer: 0.2, 0.6, 1.5 mg per kg of b.w.; in winter: 0.3, 1.5, 2.7 mg per kg of b.w.) via intratracheal instillation once every 3 days for 60 days. The results showed that exposure to high dosages of PM2.5 caused the following: (1) hepatic histopathological changes and liver function decline through elevating the activities of AST, ALT, CYP450 and GST; (2) triggered liver fibrosis, in which TGF-β1, Col I, Col III, and MMP13 mRNA and protein expression were significantly upregulated, and enhanced inflammation with the overexpression of TNF-α, IL-6 and HO-1 versus the control; (3) induced liver ER stress and cell apoptosis via activating the GRP78/ATF6/CHOP/TRB3/caspase 12 pathway. The data also indicated that the liver injury induced by winter PM2.5 in Taiyuan was more serious compared to that induced by summer PM2.5. This work provides new insight into the mechanisms of PM2.5-induced liver injury, and aids the understanding of the underlying mechanisms by which PM2.5 might affect liver diseases.
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Affiliation(s)
- Ruijin Li
- Institute of Environmental Science , Institute of Biotechnology Shanxi University , Taiyuan , PR China . ; ; Tel: (+86)-351-7011011
| | - Mei Zhang
- Institute of Environmental Science , Institute of Biotechnology Shanxi University , Taiyuan , PR China . ; ; Tel: (+86)-351-7011011
| | - Ying Wang
- Institute of Environmental Science , Institute of Biotechnology Shanxi University , Taiyuan , PR China . ; ; Tel: (+86)-351-7011011
| | - Ken Kin Lam Yung
- Institute of Environmental Science , Institute of Biotechnology Shanxi University , Taiyuan , PR China . ; ; Tel: (+86)-351-7011011
- State Key Laboratory of Environmental and Biological Analysis , Department of Biology , Hong Kong Baptist University , Hong Kong SAR , China . ; ; Tel: (+852)-34117070
| | - Ruijun Su
- Institute of Environmental Science , Institute of Biotechnology Shanxi University , Taiyuan , PR China . ; ; Tel: (+86)-351-7011011
| | - Zhuoyu Li
- Institute of Environmental Science , Institute of Biotechnology Shanxi University , Taiyuan , PR China . ; ; Tel: (+86)-351-7011011
| | - Liping Zhao
- Shanxi Provincial People's Hospital , Taiyuan , PR China
| | - Chuan Dong
- Institute of Environmental Science , Institute of Biotechnology Shanxi University , Taiyuan , PR China . ; ; Tel: (+86)-351-7011011
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis , Department of Biology , Hong Kong Baptist University , Hong Kong SAR , China . ; ; Tel: (+852)-34117070
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Chi J, Xie Q, Jia J, Liu X, Sun J, Chen J, Yi L. Prognostic Value of Albumin/Globulin Ratio in Survival and Lymph Node Metastasis in Patients with Cancer: A Systematic Review and Meta-analysis. J Cancer 2018; 9:2341-2348. [PMID: 30026830 PMCID: PMC6036713 DOI: 10.7150/jca.24889] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/14/2018] [Indexed: 02/05/2023] Open
Abstract
The impact of albumin to globulin ratio (AGR) on the prognosis of various human cancers has not been well established. Here, a systemic review and meta-analysis has been performed to comprehensively assess the relationships between AGR and lymph node metastasis (LNM) or overall survival (OS). Systematical search through six electronic databases has been carried out to identify reports involving the role of AGR on OS and LNM in human cancers. Hazard ratio (HR), odd ratio (OR) and their 95% confidence intervals (95% CI) were evaluated through meta-analysis according to standard steps. Of 403 studies retrieved, 14 eligible studies with 4136 patients were included in this study. The analysis based on random-effect model demonstrated that low AGR was significantly associated with poor OS in various cancers (HR=1.87, 95% CI 1.50-2.34; P < 0.001). Subsequent results showed a significant increase in the risk of LNM in the low AGR group when compared with high AGR group (HR=2.24; 95% CI=1.49-3.36; P<0.001). To conclusion, this study suggested that AGR was associated with OS and LNM in cancer patients and AGR may be a potential marker to assess prognosis of cancer patients. However, a large scale of samples and prospective studies are needed in the future to validate the role of AGR in practice.
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Affiliation(s)
- Jieshan Chi
- Department of neurology, Peking University Shenzhen Hospital, Shenzhen 518036, China
- Shantou University Medical College, Shantou 515041, China
| | - Qizhi Xie
- Department of neurology, Peking University Shenzhen Hospital, Shenzhen 518036, China
- Shantou University Medical College, Shantou 515041, China
| | - Jingjing Jia
- Department of neurology, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Xiaoma Liu
- Department of neurology, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Jingjing Sun
- Department of neurology, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Junhui Chen
- Department of Minimally Invasive Intervention, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Li Yi
- Department of neurology, Peking University Shenzhen Hospital, Shenzhen 518036, China
- ✉ Corresponding author: Li Yi, , Tel No.: (+86)13823688918
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Lv GY, An L, Sun XD, Hu YL, Sun DW. Pretreatment albumin to globulin ratio can serve as a prognostic marker in human cancers: a meta-analysis. Clin Chim Acta 2017; 476:81-91. [PMID: 29170102 DOI: 10.1016/j.cca.2017.11.019] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/19/2017] [Accepted: 11/20/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE Our meta-analysis aims to investigate the prognostic role of pretreatment albumin to globulin ratio (AGR) in human cancers. METHODS Available databases were searched up to Sept 25th, 2017. Pooled hazard ratios (HRs) and risk ratio (RRs) with their corresponding 95% confidence intervals (CIs) were used to assess the prognostic impact of AGR on overall survival (OS)/disease-free survival (DFS)/progression-free survival (PFS) and 5-year mortality respectively. RESULTS Totally, 28 studies with 15 356 cancer patients were included. Our results demonstrated that low pretreatment AGR is associated with poor OS (HR=2.08, 95%CI:1.78-2.44, univariate results; HR=1.75, 95%CI:1.56-1.97, multivariate results), poor DFS (HR=1.96, 95%CI:1.48-2.59, univariate results; HR=1.64, 95%CI:1.26-2.14, multivariate results) and poor PFS (HR=1.89, 95%CI:1.61-2.22, univariate results; HR=1.66, 95%CI:1.32-2.0, multivariate results). Meanwhile, low pretreatment AGR is also associated with increased 5-year mortality (RR=2.12, 95%CI:1.48-3.03). Moreover, this significant correlation was not altered by stratified analysis according to publication times, sample sizes, patient origins, AGR cutoff values, cancer systems, treatment methods or HR sources. CONCLUSION Low pretreatment AGR is associated with poor prognosis in human cancers, and AGR should be used as a prognostic marker during cancer therapy.
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Affiliation(s)
- Guo-Yue Lv
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin, China
| | - Lin An
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin, China
| | - Xiao-Dong Sun
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin, China
| | - Yue-Lei Hu
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin, China
| | - Da-Wei Sun
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin, China.
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He J, Pan H, Liang W, Xiao D, Chen X, Guo M, He J. Prognostic Effect of Albumin-to-Globulin Ratio in Patients with solid tumors: A Systematic Review and Meta-analysis. J Cancer 2017; 8:4002-4010. [PMID: 29187875 PMCID: PMC5706002 DOI: 10.7150/jca.21141] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023] Open
Abstract
Background: Albumin and globulin are main components of serum protein. The level of albumin and globulin partially represents the nutrition status and immune system. Albumin-to-globulin ratio (AGR) has been reported as a prognostic factor in various cancers. We therefore performed a meta-analysis to elucidate the prognosis effect of AGR on survival outcomes in solid tumors. Method: Six electronic database were searched for the relevant articles that assessing the prognostic value of pre-treatment AGR in solid tumor patients. The primary outcome was overall survival (OS) and the secondary outcomes were cancer-specific survival (CSS), disease-free survival (DFS) and disease-metastasis-free survival (DMFS). The time-to-event outcomes were summarized in hazard ratio (HR) and 95% confidence interval (CI). Result: A total of 13890 solid tumor patients in 24 studies were included. The AGR higher than the cut-off values ranging from 1.15-1.75 was related to better OS (HR=0.58, 95%CI 0.537-0.626, p<0.0001), CSS (HR=0.287, 95%CI 0.187-0.438, p<0.0001), DFS (HR=0.792, 95%CI 0.715-0.878, p<0.0001) and DMFS (HR=0.595, 95%CI 0.447-0.792, p<0.0001). According to the cut-off values, subgroup analysis showed that AGR had significant prognostic effect on OS in each cut-off intervals (≤1.20, 1.20-1.40 and ≥1.40). Conclusion: Pre-treatment AGR is an effective prognostic factor and high AGR represents an ideal clinical outcome in the solid tumor patients.
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Affiliation(s)
- Jiaxi He
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Hui Pan
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Wenhua Liang
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Dakai Xiao
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Xuewei Chen
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Minzhang Guo
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
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Shimizu T, Ishizuka M, Suzuki T, Tanaka G, Park KH, Matsumoto T, Shiraki T, Sakuraoka Y, Kato M, Aoki T, Kubota K. The preoperative globulin-to-albumin ratio, a novel inflammation-based prognostic system, predicts survival after potentially curative liver resection for patients with hepatocellular carcinoma. J Surg Oncol 2017; 116:1166-1175. [PMID: 28853157 DOI: 10.1002/jso.24772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/24/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Although the globulin-to-albumin ratio (GAR) is useful for prognostication of patients with various cancers, its relationship with hepatocellular carcinoma (HCC) remains unclear. The study aims to investigate the relationship between GAR and postoperative survival among patients with HCC undergoing potentially curative liver resection (LR). METHODS We retrospectively reviewed 368 patients with newly diagnosed HCC who underwent initial and potentially curative LR. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with overall survival (OS). Kaplan-Meier analysis and log-rank test were used to compare OS and disease-free survival (DFS). RESULTS The result of multivariate analysis using 25 clinical characteristics selected by univariate analysis revealed that the GAR (≥0.918/<0.918) was significantly associated with OS (hazard ratio [HR], 2.398; 95% confidence interval [CI], 1.012-5.683; P = 0.047), as well as platelet count (<14/≥14, ×104 /mm3 ) and portal vein invasion (presence/absence). Kaplan-Meier analysis and log-rank test demonstrated that the OS and DFS of patients with a high GAR (>0.918) were significantly worse than that of patients with a low GAR (≤0.918). CONCLUSIONS The GAR is a useful predictor of postoperative survival among patients with HCC undergoing potentially curative LR.
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Affiliation(s)
- Takayuki Shimizu
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Mitsuru Ishizuka
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Takashi Suzuki
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Genki Tanaka
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Kyung Hwa Park
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | | | - Takayuki Shiraki
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Yuhki Sakuraoka
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Masato Kato
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Taku Aoki
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Keiichi Kubota
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
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Altan M, Haberal HB, Akdoğan B, Özen H. A critical prognostic analysis of neutrophil-lymphocyte ratio for patients undergoing nephroureterectomy due to upper urinary tract urothelial carcinoma. Int J Clin Oncol 2017; 22:964-971. [PMID: 28600686 DOI: 10.1007/s10147-017-1150-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/31/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND To determine preoperative serum complete blood count parameters that affects survival of patients who underwent surgery for upper urinary tract urothelial cancer (UUT-UC). METHODS Since 1990, 150 patients underwent nephroureterectomy with bladder cuff excision for UUT-UC at Hacettepe University. Patients with a history of muscle-invasive bladder cancer, adjuvant chemotherapy or metastasis at the time of diagnosis were excluded. One hundred and thirteen patients without infective symptoms and with a full set of serum data were evaluated retrospectively. Effects of the neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and leukocyte count on disease-free survival (DFS) and progression-free survival (PFS) were investigated. Threshold values for each parameter to predict PFS were calculated. RESULTS The mean age and median follow-up were 63.7 ± 11.1 years and 34 (3-186) months, respectively. Male to female ratio was 86/27. The 5-years PFS (bladder recurrence was excluded) and DFS were 59.6 and 38.4%, respectively. In multivariate analysis, NLR was independent prognostic factor for PFS and DFS (p = 0.006 and p = 0.021, respectively) while LMR was prognostic only for PFS (p = 0.037). CONCLUSION For UUT-UC, NLR is a prognostic factor for PFS and DFS, while LMR is a prognostic indicator for PFS in present series.
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Affiliation(s)
- Mesut Altan
- Department of Urology, Hacettepe University School of Medicine, 06230, Ankara, Turkey
| | - Hakan Bahadır Haberal
- Department of Urology, Hacettepe University School of Medicine, 06230, Ankara, Turkey.
| | - Bülent Akdoğan
- Department of Urology, Hacettepe University School of Medicine, 06230, Ankara, Turkey
| | - Haluk Özen
- Department of Urology, Hacettepe University School of Medicine, 06230, Ankara, Turkey
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