The predictive value of preoperative albumin-to-globulin ratio in patients with hilar cholangiocarcinoma

Background:To investigate the associations between preoperative albumin-to-globulin ratio and clinicalpathological factors,and the impacts of albumin-to-globulin ratio on the longterm outcomes and postoperative complications in hilar cholangiocarcinoma.Methods:Ninety-seven hilar cholangiocarcinoma patients were enrolled in our study.The clinicalpathological and survival information were collected.Correlation analysis was using chi-square test and logistic regression.Univariate analysis was done by Log-rank test,multivariate analysis was performed using the Cox proportional hazard regression model.Results:The optimal cutoff value of the preoperative albumin-to-globulin ratio was set at 1.34,The albumin-to-globulin ratio level was elevated in 49 hilar cholangiocarcinoma patients,while other 48 hilar cholangiocarcinoma patients were with low level.Tumor stage(OR=2,621;P=0.003)and lymph node metastasis(OR=3.704;P=0.004)were identified as independently risks of albumin-to-globulin ratio level in hilar cholangiocarcinoma patients.Multivariate Cox proportional hazard regression model found differentiation(HR=1.989;P=0.014),tumor stage(HR=1.480;P=0.014)and albumin-to-globulin ratio level(HR=0.037;P=0.017)were identified as the independent factors of the overall survival.Furthermore,we found the low albumin-toglobulin ratio level(OR=0.037;P=0.017)was an independent risk factor for the incidence of postoperative complications.Conclusions:Preoperative albumin-to-globulin ratio is a simple and useful marker not only to identify patients at increased risk for postoperative complications,but also to predict long-term survival.