Preoperative albumin-globulin ratio and prognosis of patients with esophageal squamous cell carcinoma / 中华疾病控制杂志

ABSTRACT

Objective To investigate the relationship between albumin/globulin ratio (AGR) and postoperative survival among patients with esophageal squamous cell carcinoma(ESCC) undergoing radical oesophagectomy, to establish an effective prognostic nomogram for ESCC and to provide a reference for prognosis prediction of ESCC. Methods From February 2014 to September 2017, 390 ESCC patients who underwent surgery were retrospectively enrolled from the tumor hospital in Fujian Province. The receiver operating characteristic curves(ROC) were applied to establish optimal cutoff points. Chi-square test was used to estimate the relationship between the AGR and the clinical features. Cox proportional hazards model was used to estimate the HR and 95% CI for the associations between AGR and Prognosis of ESCC patients. A nomogram model was established to predict the outcome of ESCC patients. Results The ROC demonstrated the best cutoff value for AGR was 1.16. A total of 356 patients were recruited in the final analysis, who were divided into the high AGR group (≥1.16) and the low AGR group (<1.16) by the best cutoff value. Both 1-year and 3-year survival rates in the high AGR group were higher than those detected in the low AGR group(all P<0.05). Multivariate analysis showed that the T stage, N stage, and AGR were independent prognostic factors of overall survival(all P<0.05). The HR of T stage was 1.87 (T3-T4 vs T1-T2, 95% CI 1.04-3.35); The HR of N stage was1.89 (N+ vs N0, 95% CI 1.13-3.17); The HR of AGR was 0.57(the high AGR group vs the low AGR group, 95%CI 0.36-0.90). The concordance index(C-index) of the nomogram to predict overall survival was 0.68 (95% CI 0.62-0.73，P<0. 001)．Conclusions The AGR was an independent prognosis factor for operated ESCC patients. The prognosis of ESCC in the high AGR group was better than that in the low AGR group and the prognostic nomogram provides individualized risk estimate of survival in ESCC patients after surgery.