RESUMEN
Objective:To analyze the preoperative albumin-globulin ratio (AGR) of patients with low rectal cancer, and explore its correlation with the clinical outcome of patients after surgery.Methods:One hundred and fifty-two patients who underwent radical resection of low rectal cancer at the General Surgery Department of the First Affiliated Hospital of Xinjiang Medical University from June 2013 to June 2015 were selected as the research objects. According to the clinical outcome of the patients, the patients were divided into survival group (128 cases) and death group (24 cases). The general clinical data and preoperative and postoperative serum ALB, GLB, and AGR levels of the two groups of patients were compared; multivariate logistic regression analysis of factors affecting postoperative death of patients; a nomogram prediction model was constructed and verified based on the independent risk factors selected ; ROC curve analyzes the predictive value of AGR for patients′ clinical outcomes, and obtains the best cut-off value; analyzes the correlation between AGR and postoperative clinical outcomes of patients; divides patients into group A and group B according to the cut-off value, and draws by Kaplan-Meier method Survival curve, comparing the survival rate of the two groups of patients during the 5-year follow-up period.Results:In the survival group, the number of tumor stages was Ⅰ, Ⅱ, and Ⅲ, the number of cells with high/moderate differentiation, the depth of tumor invasion was T1/T2, the number, the number of lymph node metastasis, the number of chemotherapy, the preoperative ALB, GLB, and AGR levels were 68 cases, respectively, 42 cases, 18 cases, 99 cases, 95 cases, 108 cases, 60 cases, (43.52±6.73) g/L, (23.75±4.38) g/L, 1.90±0.34, the death group was 6 cases and 11 cases respectively, 7 cases, 15 cases, 17 cases, 18 cases, 8 cases, (39.42±4.28) g/L, (26.58±4.12) g/L, 1.62±0.45, the difference was statistically significant ( t/ χ2=18.695, 4.455, 5.120, 3.742, 2.137, 2.873, 2.931, 3.506, all P<005), all of which were independent risk factors leading to death. ALB, GLB, and AGR in the survival group were (38.72±5.69) g/L and (24.13±4.56), respectively g/L, 1.60±0.35, ALB and AGR were significantly lower than before operation ( t=6.162, 6.956, both P<005), and the death group were (34.18±4.37) g/L and (26.92±4.25) g/L, respectively, 1.27±0.39, ALB and AGR were significantly lower than before operation ( t=4.197, 2.879, both P<005), ALB and AGR of the death group were significantly lower than those of the survival group, and GLB was significantly higher than that of the survival group, the difference was statistically significant ( t=3.705, 2.779, 4.162, all P<005); the best cut-off value of AGR predicting patient death was 1.73; AGR≤1.73 was closely related to postoperative recurrence and death ( OR=1.18, 1.23, 95% CI: 1.02-1.59, 1.08-1.64, both P<005); the number of survivors of patients with AGR>1.73 was 98, which was significantly higher than that of patients with AGR≤1.73 (30 cases). The difference is statistically significant ( χ2=24.869, P<0.05). Conclusion:The preoperative serum AGR level is an independent risk factor affecting the postoperative clinical outcome of patients with low rectal cancer. Patients with a low level of AGR are at greater risk of postoperative death. The preoperative serum AGR level has a higher predictive value for the patient′s clinical outcome.