术前外周血清蛋白与球蛋白比值在非转移性肾透明细胞癌预后预测中的价值

Value of preoperative peripheral blood albumin-to-globulin ratio in predicting the prognosis of non-metastatic clear cell renal cell carcinoma

目的探讨术前外周血清蛋白与球蛋白比值(AGR)对非转移性肾透明细胞癌(NMCCRCC)患者预后预测中的价值。方法回顾性分析2012年1月至2014年12月大连大学附属中山医院收治的61例术后病理确诊为NMCCRCC患者的临床病理及术后随访资料。根据受试者工作特征曲线(ROC)确定AGR最佳截点值,根据截点值分为高AGR组(AGR≥1.59)和低AGR组(AGR<1.59)。对影响NMCCRCC患者预后的因素进行单因素和多因素分析。结果61例NMCCRCC患者中,高AGR组38例(62.3%),低AGR组23例(37.7%)。两组患者年龄、球蛋白水平、临床分期、复发情况比较,差异均有统计学意义(均P<0.05)。低AGR组的总生存时间、无病生存时间均短于高AGR组,差异均有统计学意义(均P<0.05)。多因素Cox回归分析显示,AGR<1.59是患者总生存及复发的独立影响因素(HR=0.233,95%CI 0.073~0.742,P=0.014;HR=0.343,95%CI 0.134~0.873,P=0.025)。结论术前AGR对NMCCRCC患者预后有预测价值。

Objective To investigate the prognostic value of preoperative peripheral blood albumin-to-globulin ratio(AGR)for patients with non-metastatic clear cell renal cell carcinoma(NMCCRCC).Methods The clinicopathological and postoperative follow-up data of 61 patients with NMCCRCC confirmed by postoperative pathology who were admitted to Zhongshan Hospital of Dalian University from January 2012 to December 2014 was retrospectively analyzed.According to the receiver operating characteristic curve(ROC),the optimal cut-off value of AGR was determined.According to the cut-off value,the patients were divided into high AGR group(AGR≥1.59)and low AGR group(AGR<1.59).The factors affecting the prognosis of NMCCRCC patients were analyzed by using univariate and multivariate analyses.Results Among 61 patients with NMCCRCC,38 cases(62.3%)were in high AGR group and 23 cases(37.7%)were in low AGR group.The differences in age,globulin level,clinical staging,and recurrence status between the two groups were statistically significant(all P<0.05).The overall survival time and disease-free survival time in low AGR group were shorter than those in high AGR group,and the differences were statistically significant(both P<0.05).Multivariate Cox regression analysis showed that AGR<1.59 was the independent influencing factor for overall survival and recurrence(HR=0.233,95%CI 0.073-0.742,P=0.014;HR=0.343,95%CI 0.134-0.873,P=0.025).Conclusion Preoperative AGR is valuable in predicting the prognosis of NMCCRCC patients.