不同分期膀胱癌患者白蛋白与球蛋白比值的临床意义

Clinical significance of the albumin to globulin ratio in patients with different stages of bladder cancer

目的探讨不同分期膀胱癌患者白蛋白与球蛋白比值(AGR)的临床意义。方法收集2013年5月至2016年9月中国医科大学附属第四医院115例非肌层浸润性膀胱癌患者(NMIBC组)、36例肌层浸润性膀胱癌患者(MIBC组)以及49例正常健康体检者(对照组)临床资料。根据受试者工作特征(ROC)曲线确定NMIBC组、MIBC组术后出现复发及转移的AGR最佳截断值,根据最佳截断值比较不同分期膀胱癌患者的临床指标、3年无复发生存率及3年无瘤生存率。结果3组两两比较AGR均存在统计学差异(均P<0.05)。NMIBC组AGR与患者肿瘤分期、肿瘤大小及肿瘤分级相关(均P<0.05),低AGR组(AGR≤1.37)3年无复发生存率明显低于高AGR组(AGR>1.37,P<0.05)。MIBC组AGR与患者肿瘤分期相关(均P<0.05),低AGR组(AGR≤1.33)3年无瘤生存率明显低于高AGR组(AGR>1.33,P<0.05)。结论AGR与膀胱癌肿瘤分期相关,低AGR患者的3年无复发生存率、3年无瘤生存率均低于高AGR患者。临床上AGR可作为评估不同分期膀胱癌预后的生物学标志物。

Objective To investigate the clinical significance of the albumin to globulin ratio(AGR)in patients with different stages of bladder cancer.Methods The clinical data of 115 patients with non-muscular invasive bladder cancer(NMIBC group),36 patients with muscular invasive bladder cancer(MIBC group),and 49 healthy participants(control group)were collected from the Fourth Affiliated Hospital of China Medical University between May 2013 and September 2016.The optimal cut-off value of AGR for postoperative recurrence and metastasis in the NMIBC and the MIBC groups was determined according to the receiver operating characteristic curve,and the clinical data and the 3-year recurrence-free and 3-year tumor-free survival rates of the different stages of bladder cancer were compared based on the optimal cut-off values.Results There were significant differences in AGR among the three groups(all P<0.05).In the NMIBC group,AGR was correlated with tumor stage,tumor size,and tumor grade(all P<0.05).The 3-year recurrence-free survival rate of the low AGR group(AGR≤1.37)was significantly lower than that of the high AGR group(AGR>1.37,P<0.05).In the MIBC group,AGR was correlated with tumor stage,and the 3-year tumor-free survival rate of the low AGR group(AGR≤1.33)was significantly lower than that of the high AGR group(AGR>1.33,P<0.05).Conclusion AGR was associated with the tumor stage of bladder cancer.The 3-year recurrence-free and the 3-year tumor-free survival rates of the low AGR patients were lower than those of the high AGR patients.Clinically,AGR can be used as a biomarker for evaluating the prognosis of bladder cancer at different stages.