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Preoperative Albumin Level Is Superior To Albumin-Globulin Ratio As A Predicting Indicator In Gastric Cancer Patients Who Underwent Curative Resection

Authors Xiao S, Feng F, Liu N, Liu Z, Guo Y, Lian X, Zhang H

Received 11 September 2019

Accepted for publication 18 October 2019

Published 25 November 2019 Volume 2019:11 Pages 9931—9938


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Chien-Feng Li

Shuao Xiao,1,* Fan Feng,1,* Ni Liu,2,* Zhen Liu,1 Yinghao Guo,3 Xiao Lian,1 Hongwei Zhang1

1Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an 710032, Shaanxi, People’s Republic of China; 2Department of Anesthesiology, Weinan Central Hospital, Weinan 714000, Shaanxi, People’s Republic of China; 3Health Company, 92667 Army of PLA, Qingdao 266100, Shandong, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Hongwei Zhang; Fan Feng
Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 127 West Changle Road, Xi’an 710032, Shaanxi, People’s Republic of China
Tel/Fax +86-029-84771531

Objective: The preoperative value of albumin level and albumin/globulin ratio (AGR) has been discovered to be a possibility for predicting gastric cancer. However, their predictive accuracy remains unknown. This study’s objective is to evaluate the predictive value of albumin, globulin and AGR in gastric cancer.
Methods: A total of 3266 gastric cancer patients in our institution who underwent radical gastrectomy during the period from September 2008 to April 2015 were retrospectively analyzed. Levels of preoperative serum albumin and globulin were recorded. The optimal cut off points of albumin, globulin and AGR were calculated using X-tile software. The association of albumin and AGR with clinicopathological features and eventual prognosis was analyzed. The survival predictive accuracy and prognostic discriminatory ability among different variables were analyzed.
Results: This study consisted of 2531 males (77.5%) and 735 females (22.5%). Ages ranged from 20 to 90, with a median age of 58.0 years. The optimal cut off values of albumin, globulin and AGR were set at 42.0, 28.2 and 1.80, respectively. Patients in the high albumin group and high AGR group were both associated with younger age, smaller tumor size, as well as earlier T and N stages. Univariate and multivariate analysis demonstrated that albumin level and AGR value were both significant prognostic factors, while globulin level was not. Furthermore, albumin level displayed a prognostic discriminatory ability and a predictive accuracy superior to that of AGR. The multivariate model based on albumin also revealed a superior predictive accuracy than that based on AGR.
Conclusion: Preoperative albumin level is superior to AGR value in the prediction of prognosis of gastric cancer.

Keywords: albumin-globulin ratio, albumin, gastric cancer, prognosis

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