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International Journal of Clinical Oncology

Erschienen in:

08.07.2023 | Review Article

The efficacy of albumin–globulin ratio to predict prognosis in cancer patients

verfasst von: Will S. Roberts, William Delladio, Shawn Price, Alec Murawski, Hoang Nguyen

Erschienen in: International Journal of Clinical Oncology | Ausgabe 9/2023

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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.

Siegel RL, Miller KD, Fuchs HE et al (2022) Cancer statistics, 2022. CA Cancer J Clin 72(1):7–33. https://doi.org/10.3322/caac.21708CrossRefPubMed

Tur-Sinai A, Urban D, Azoulay D et al (2022) Understanding out-of-pocket spending and financial hardship among patients who succumb to cancer and their caregivers. Israel J Health Policy Res 11(1):1–1. https://doi.org/10.1186/s13584-021-00511-8CrossRef

Khorana AA, Tullio K, Elson P et al (2019) Time to initial cancer treatment in the United States and association with survival over time: an observational study. PLoS ONE 14(3):e0213209. https://doi.org/10.1371/journal.pone.0213209CrossRefPubMedPubMedCentral

Zhang Y et al (2020) Predicting the prognosis of gastric cancer by albumin/globulin ratio and the prognostic nutritional index. Nutr Cancer 72(4):635–644PubMedCrossRef

Wang Y et al (2019) The prognostic value of serum albumin-globulin ratio in early-stage non-small cell lung cancer: a retrospective study. Cancer Manag Res 11:3545–3554PubMedPubMedCentralCrossRef

U.S. National Library of Medicine (2022) Total protein and albumin/globulin (A/G) ratio: Medlineplus medical test. MedlinePlus. Retrieved November 25, 2022. https://medlineplus.gov/lab-tests/total-protein-and-albumin-globulin-a-g-ratio/

Toiyama Y et al (2017) Clinical impact of preoperative albumin to globulin ratio in gastric cancer patients with curative intent. Am J Surg 213(1):120–126PubMedCrossRef

Mao MJ et al (2017) Clinical significance of preoperative albumin and globulin ratio in patients with gastric cancer undergoing treatment. BioMed Res Int

Chen WZ et al (2017) Preoperative albumin/globulin ratio has predictive value for patients with laryngeal squamous cell carcinoma. Oncotarget 8(29):48240–48247PubMedPubMedCentralCrossRef

10.

Zhou T et al (2016) Pretreatment albumin/globulin ratio predicts the prognosis for small-cell lung cancer. Medicine (United States) 95(12):e3097

11.

Otsuka M et al (2018) Prognostic role of the preoperative serum albumin: globulin ratio after radical nephroureterectomy for upper tract urothelial carcinoma. Int J Urol 25(10):871–878PubMedCrossRef

12.

Busher JT (1990) Serum albumin and globulin. In: Walker HK, Hall WD, Hurst JW (eds) Clinical methods: the history, physical, and laboratory examinations, Chapter 101, 3rd edn. Butterworths, Boston.

13.

Justiz Vaillant AA, Jamal Z, Patel P et al (2022) Immunoglobulin. [Updated 2022 Sep 9]. In: StatPearls [Internet]. StatPearls Publishing, Treasure Island

14.

Lu P et al (2021) A low albumin-to-globulin ratio predicts a poor prognosis in patients with metastatic non-small-cell lung cancer. Front Med 8

15.

Gutman SI, Piper M, Grant MD et al (2013) Progression-free survival: what does it mean for psychological well-being or quality of life? Agency for Healthcare Research and Quality (US), Rockville. Report No.: 13-EHC074-EF. PMID: 23678517

16.

Zhang H et al (2019) Preoperative albumin-to-globulin ratio predicts survival in patients with non-small-cell lung cancer after surgery. J Cell Physiol 234(3):2471–2479PubMedCrossRef

17.

Xu WZ et al (2017) Preoperative albumin-to-globulin ratio and prognostic nutrition index predict prognosis for glioblastoma. Onco Targets Ther 10:725–733PubMedPubMedCentralCrossRef

18.

Guner E, Seker KG (2020) The role of preoperative albumin to globulin ratio in predicting prognosis in testicular cancer patients. Actas Urol Esp 44(7):469–476PubMedCrossRef

19.

Park S et al (2016) Pretreatment albumin-to-globulin ratio as a predictive marker for tyrosine kinase inhibitor in non-small cell lung cancer. Cancer Biomark 16(3):425–433PubMedCrossRef

20.

Azab BN et al (2013) Value of the pretreatment albumin to globulin ratio in predicting long-term mortality in breast cancer patients. Am J Surg 206(5):764–770PubMedCrossRef

21.

Li XH et al (2017) Low preoperative albumin-to-globulin ratio predict poor survival and negatively correlated with fibrinogen in resectable esophageal squamous cell carcinoma. J Cancer 8(10):1833–1842PubMedPubMedCentralCrossRef

22.

Atsumi Y et al (2021) Low preoperative albumin-to-globulin ratio is a marker of poor prognosis in patients with esophageal cancer. In Vivo 35(6):3555–3561PubMedPubMedCentralCrossRef

23.

Aktepe OH et al (2021) Impact of albumin to globulin ratio on survival outcomes of patients with metastatic renal cell carcinoma. Turk J Urol 47(2):113–119PubMedPubMedCentralCrossRef

24.

Takata N et al (2021) Usefulness of albumin–globulin ratio as a clinical prognostic factor in patients with thyroid cancer treated with radioiodine. Ann Nucl Med 35(9):1015–1021PubMedCrossRef

25.

Yalikun K et al (2020) Serum albumin levels and serum albumin-globulin ratio are associated with poor prognosis in glioblastoma. Transl Cancer Res 9(3):1594–1603PubMedPubMedCentralCrossRef

26.

Liu J et al (2016) The prognostic role of preoperative serum albumin/globulin ratio in patients with bladder urothelial carcinoma undergoing radical cystectomy. Urol Oncol Semin Orig Investig 34(11):484.e481-484.e488

27.

Xu H et al (2018) Prognostic impact of preoperative albumin-globulin ratio on oncologic outcomes in upper tract urothelial carcinoma treated with radical nephroureterectomy. Clin Genitourin Cancer 16(5):e1059–e1068PubMedCrossRef

28.

Cai Y et al (2021) Prognostic value of the albumin–globulin ratio and albumin–globulin score in patients with multiple myeloma. J Int Med Res 49(3)

29.

Xiao S et al (2019) Preoperative albumin level is superior to albumin-globulin ratio as a predicting indicator in gastric cancer patients who underwent curative resection. Cancer Manag Res 11:9931–9938PubMedPubMedCentralCrossRef

30.

Zhang L et al (2019) Potential prognostic factors for predicting the chemotherapeutic outcomes and prognosis of patients with metastatic colorectal cancer. J Clin Lab Anal 33(8)

31.

Durhan A et al (2021) Does the albumin to globulin ratio predict short-term complications in gastric cancer patients? Konuralp Tip Dergisi 13(2):175–180CrossRef

32.

Quhal F et al (2021) Prognostic value of albumin to globulin ratio in non-muscle-invasive bladder cancer. World J Urol 39(9):3345–3352PubMedPubMedCentralCrossRef

33.

Wang Z et al (2020) Prealbumin-to-globulin ratio can predict the chemotherapy outcomes and prognosis of patients with gastric cancer receiving first-line chemotherapy. J Immunol Res 2020:13CrossRef

34.

Zhou T et al (2019) Pretreatment albumin globulin ratio has a superior prognostic value in laryngeal squamous cell carcinoma patients: a comparison study. J Cancer 10(3):594–601PubMedPubMedCentralCrossRef

35.

Zhou T et al (2019) Comparison of the prognostic value of systemic inflammation response markers in small cell lung cancer patients. J Cancer 10(7):1685–1692PubMedPubMedCentralCrossRef

36.

Schuettfort VM et al (2021) Impact of preoperative serum albumin-globulin ratio on disease outcome after radical cystectomy for urothelial carcinoma of the bladder. Urol Oncol Semin Orig Investig 39(4):235.e235-235.e214

37.

Oh JS et al (2021) Decrease of preoperative serum albumin-to-globulin ratio as a prognostic indicator after radical cystectomy in patients with urothelial bladder cancer. Urol J 18(1):66–73PubMed

38.

Oki S et al (2017) Clinical burden of preoperative albumin-globulin ratio in esophageal cancer patients. Am J Surg 214(5):891–898PubMedCrossRef

39.

Liu J et al (2019) Prognostic values of preoperative albumin to globulin ratio for predicting clinical outcome in patients with high-grade gliomas. Transl Cancer Res 8:1727–1733PubMedPubMedCentralCrossRef

40.

Shibutani M et al (2015) The pretreatment albumin to globulin ratio predicts chemotherapeutic outcomes in patients with unresectable metastatic colorectal cancer. BMC Cancer 15(1)

41.

Fukushima H et al (2018) Prognostic value of albumin/globulin ratio in patients with upper tract urothelial carcinoma patients treated with radical nephroureterectomy. Anticancer Res 38(4):2329–2334PubMed

42.

Xuan Q et al (2019) Combination of the preoperative albumin to globulin ratio and neutrophil to lymphocyte ratio as a novel prognostic factor in patients with triple negative breast cancer. Cancer Manag Res 11:5125–5131PubMedPubMedCentralCrossRef

43.

Wang N et al (2019) Pretreatment serum albumin/globulin ratio as a prognostic biomarker in metastatic prostate cancer patients treated with maximal androgen blockade. Asian J Androl 21(1):56–61CrossRef

44.

Taguchi S et al (2021) Prognostic significance of the albumin-to-globulin ratio for advanced urothelial carcinoma treated with pembrolizumab: a multicenter retrospective study. Sci Rep 11(1):15623PubMedPubMedCentralCrossRef

45.

Du XJ et al (2014) The pretreatment albumin to globulin ratio has predictive value for long-term mortality in nasopharyngeal carcinoma. PLoS One 9(4)

46.

Liu J et al (2017) Prognostic value of pretreatment albumin–globulin ratio in predicting long-term mortality in gastric cancer patients who underwent D2 resection. Onco Targets Ther 10:2155–2162PubMedPubMedCentralCrossRef

47.

Liu Z et al (2017) The prognostic value of preoperative serum albumin-globulin ratio for high-grade bladder urothelial carcinoma treated with radical cystectomy: a propensity score-matched analysis. J Cancer Res Ther 13(5):837–843PubMedCrossRef

48.

Yue W et al (2018) The pretreatment albumin to globulin ratio as a significant predictor in patients with diffuse large B cell lymphoma. Clin Chim Acta 485:316–322PubMedCrossRef

49.

Xu Y et al (2019) Prognostic value of preoperative albumin to globulin ratio in elderly patients with rectal cancer. Medicine (United States) 98(24)

50.

Omura S et al (2020) Prognostic significance of the albumin-to-globulin ratio for upper tract urothelial carcinoma. BMC Urol 20(1)

51.

Azab B et al (2013) The value of the pretreatment albumin/globulin ratio in predicting the long-term survival in colorectal cancer. Int J Colorectal Dis 28(12):1629–1636PubMedCrossRef

52.

Lin Q et al (2017) Prognostic significance of preoperative albumin-to-globulin ratio in patients with cholangiocarcinoma. Curr Res Transl Med 65(2):83–87PubMed

53.

Xue F et al (2017) Preoperative albumin/globulin ratio is a potential prognosis predicting biomarker in patients with resectable gastric cancer. Turk J Gastroenterol 28(6):439–445PubMedCrossRef

54.

Kim SH et al (2018) Prognostic impact of pretreatment albumin to globulin ratio in patients with diffuse large B-cell lymphoma treated with R-CHOP. Leuk Res 71:100–105PubMedCrossRef

55.

Zhou T et al (2016) Pretreatment albumin/globulin ratio predicts the prognosis for small-cell lung cancer. Medicine (United States) 95(12)

56.

He X et al (2017) Preoperative Albumin to Globulin Ratio (AGR) as prognostic factor in renal cell carcinoma. J Cancer 8(2):258–265PubMedPubMedCentralCrossRef

57.

Utsumi M et al (2021) Preoperative albumin-to-globulin ratio predicts prognosis in hepatocellular carcinoma: a cohort study including non-hepatitis virus-infected patients. Dig Surg 38(4):307–315PubMedCrossRef

58.

Duran AO et al (2014) Albumin-globulin ratio for prediction of long-term mortality in lung adenocarcinoma patients. Asian Pac J Cancer Prev APJCP 15(15):6449–6453PubMedCrossRef

59.

Chung JW et al (2020) The prognostic role of preoperative serum albumin/globulin ratio in patients with non-metastatic renal cell carcinoma undergoing partial or radical nephrectomy. Sci Rep 10(1):11999PubMedPubMedCentralCrossRef

60.

Bozkaya Y et al (2019) Prognostic importance of the albumin to globulin ratio in metastatic gastric cancer patients. Curr Med Res Opin 35(2):275–282PubMedCrossRef

61.

Deng Y et al (2016) Prognostic significance of pretreatment albumin/globulin ratio in patients with hepatocellular carcinoma. Onco Targets Ther 9:5317–5328PubMedPubMedCentralCrossRef

62.

Fujikawa H et al (2017) Prognostic impact of preoperative albumin-to-globulin ratio in patients with colon cancer undergoing surgery with curative intent. Anticancer Res 37(3):1335–1342PubMedCrossRef

63.

Kawata A et al (2021) A low preoperative albumin-to-globulin ratio is a negative prognostic factor in patients with surgically treated cervical cancer. Int J Clin Oncol 26(5):980–985PubMedCrossRef

64.

Koparal MY et al (2018) Prognostic role of preoperative albumin to globulin ratio in predicting survival of clear cell renal cell carcinoma. Int Braz J Urol 44(5):933–946PubMedPubMedCentralCrossRef

65.

Niwa N et al (2018) Prognostic value of pretreatment albumin-to-globulin ratio in patients with non-muscle-invasive bladder cancer. Clin Genitourin Cancer 16(3):e655–e661PubMedCrossRef

66.

Solanki SL et al (2021) Cancer related nutritional and inflammatory markers as predictive parameters of immediate postoperative complications and long-term survival after hepatectomies. Surg Oncol 37

67.

Zhang B et al (2015) Prognostic significance of preoperative albumin-globulin ratio in patients with upper tract urothelial carcinoma. PLoS One 10(12)

68.

Zhong B et al (2020) Prognostic value of the pretreatment albumin:globulin ratio combined with adult comorbidity evaluation 27 and TMN staging in patients with squamous cell carcinoma of the maxillary sinus. Br J Oral Maxillofac Surg 58(2):170–178PubMedCrossRef

Titel: The efficacy of albumin–globulin ratio to predict prognosis in cancer patients
verfasst von: Will S. Roberts
William Delladio
Shawn Price
Alec Murawski
Hoang Nguyen
Publikationsdatum: 08.07.2023
Verlag: Springer Nature Singapore
Erschienen in: International Journal of Clinical Oncology / Ausgabe 9/2023
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-023-02380-4

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