Prognostic Importance of Albumin Globulin Ratio in Small Cell Lung Cancer

Year 2019, Volume: 19 Issue: 4, 729 - 735, 28.11.2019

Burak Bilgin Mehmet Ali Nahit Sendur , Şebnem Yücel Mutlu Hizal Bülent Yalçın

https://doi.org/10.17098/amj.651978

Cited By: 2

Abstract

Objectives: Inflammation has an important role for tumor development and also associated with poor prognosis in various cancer types. Albumin and globulin are two biomarkers that can reflect inflammation. However, albumin level can be affected in many conditions. Thus, albumin-globulin ratio (AGR) was found as a more successful biomarker for reflection of inflammation compared with albumin alone. In this article, we aim that investigated to the prognostic effect of AGR in small cell lung cancer (SCLC).
Materials and Methods: We analyzed the patients who were diagnosed with SCLC between 2014-2018, retrospectively. AGR was calculated by divided albumin to globulin level at the diagnosis. Cut off level for AGR was accepted as 1.2.
Results: totally, 81 patients were enrolled to study. Percent of patients with AGR < 1.2 were 40.30% and AGR ≥ 1.2 were 50.30%. Patients characteristics were similar between the groups. We found that negative correlation between AGR and neutrophil-lymphocyte ratio and platelet-lymphocyte ratio, significantly. Progression free survival and overall survival were longer in AGR ≥ 1.2 group.
Conclusion: AGR is a cheap and easy biomarker. Thus, it can be used for prognostic biomarker for SCLC.

Keywords

Albumin, globulin, inflammation, survival

Albümin Globulin Oranının Küçük Hücreli Akciğer Kanserinde Prognostik Önemi

Abstract

Giriş: İnflamasyon kanser gelişimini kolaylaştırmanın yanı sıra birçok kanser tipinde kötü prognozla da ilişkilidir. Albümin ve globülin inflamasyonu yansıtan belirteçlerden ikisidir. Albüminin özellikle inflamasyon dışı birçok nedenden etkilenebileceği için albümin globülin oranının inflamasyonu yansıtmada daha başarılı olacağı gösterilmiştir. Biz bu çalışmada albümin globülin oranın (AGO) küçük hücreli akciğer kanserinde (KHAK) prognostik öneminin belirlenmesi ve diğer inflamatuar parametrelerle ilişkisinin saptanmasını amaçladık.
Materyal ve Metot: Retrospektif olarak 2014-2018 yılları arasından tanı almış KHAK hastaları çalışmaya dâhil edildi. Tanı anındaki albümin globüline bölünerek AGO bulundu. Medyan değer olan 1,2 AGO için eşik değer olarak kabul edildi.
Bulgular: Toplam 81 hasta çalışmaya dâhil edildi. Hastaların %40,30’ü AGO < 1,2 olarak saptanırken, % 59,30’ünün ise AGO ≥ 1,2 olarak bulundu. Her iki grup hasta özellikleri açısından benzerdi. AGO ile nötrofil lenfosit oranı ve platelet lenfosit oranı arasında istatistiksel anlamlı ters korelasyon saptandı. AGO ≥ 1,2 olan grupta hem progresyonsuz sağkalım hem de genel sağkalım istatistiksel olarak daha uzundu.
Sonuç: AGO hem kolay uygulanabilir hem de ucuz bir belirteç olması nedeniyle KHAK’de prognostik belirteç olarak kullanılabilir.

Keywords

Albümin, globulin, inflamasyon, sağ kalım

References

• Govindan R, Page N, Morgensztern D, ve ark. Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol. 2006;24(28):4539-44. (doi:10.1200/JCO.2005.04.4859).
• Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34. (doi:10.3322/caac.21551).
• Paesmans M, Sculier JP, Lecomte J, ve ark. Prognostic factors for patients with small cell lung carcinoma: analysis of a series of 763 patients included in 4 consecutive prospective trials with a minimum follow-up of 5 years. Cancer. 2000;89(3):523-33.
• Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436-44. (doi:10.1038/nature07205).
• Cedres S, Torrejon D, Martinez A, ve ark. Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer. Clin Transl Oncol. 2012;14(11):864-9. (doi:10.1007/s12094-012-0872-5).
• Gu X, Sun S, Gao XS, ve ark. Prognostic value of platelet to lymphocyte ratio in non-small cell lung cancer: evidence from 3,430 patients. Sci Rep. 2016;6:23893. (doi:10.1038/srep23893).
• Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69. (doi:10.1186/1475- 2891-9-69).
• Yildirim M, Yildiz M, Duman E, Goktas S, Kaya V. Prognostic importance of the nutritional status and systemic inflammatory response in non-small cell lung cancer. J BUON. 2013;18(3):728-32.
• Li X, Qin S, Sun X, ve ark. Prognostic Significance of Albumin-Globulin Score in Patients with Operable Non-Small-Cell Lung Cancer. Ann Surg Oncol. 2018;25(12):3647- 59. (doi:10.1245/s10434-018-6715-z).
• Yao Y, Zhao M, Yuan D, Gu X, Liu H, Song Y. Elevated pretreatment serum globulin albumin ratio predicts poor prognosis for advanced non-small cell lung cancer patients. J Thorac Dis. 2014;6(9):1261-70. (doi:10.3978/j.issn.2072-1439.2014.07.13).
• Duran AO, Inanc M, Karaca H, ve ark. Albumin-globulin ratio for prediction of long-term mortality in lung adenocarcinoma patients. Asian Pac J Cancer Prev. 2014;15(15):6449-53.
• Lv GY, An L, Sun XD, Hu YL, Sun DW. Pretreatment albumin to globulin ratio can serve as a prognostic marker in human cancers: a meta-analysis. Clin Chim Acta. 2018;476:81-91. (doi:10.1016/j.cca.2017.11.019).
• Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883-99. (doi:10.1016/j.cell.2010.01.025).
• Templeton AJ, McNamara MG, Seruga B, ve ark. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124. (doi:10.1093/jnci/dju124).
• Chi J, Xie Q, Jia J, ve ark. Prognostic Value of Albumin/Globulin Ratio in Survival and Lymph Node Metastasis in Patients with Cancer: A Systematic Review and Meta- analysis. J Cancer. 2018;9(13):2341-8. (doi:10.7150/jca.24889).
• Zhang Y, Wang L, Lin S, Wang R. Preoperative albumin-to-globulin ratio as a significant prognostic indicator in urologic cancers: a meta-analysis. Cancer Manag Res. 2018;10:4695-708. (doi:10.2147/CMAR.S178271).
• Zhang H, Zhang B, Zhu K, ve ark. Preoperative albumin-to-globulin ratio predicts survival in patients with non-small-cell lung cancer after surgery. J Cell Physiol. 2019;234(3):2471-9 (doi:10.1002/jcp.26766).
• Sandfeld-Paulsen B, Meldgaard P, Sorensen BS, Safwat A, Aggerholm-Pedersen N. The prognostic role of inflammation-scores on overall survival in lung cancer patients. Acta Oncol. 2019;10.1080/0284186X.2018.1546057:1-6. (doi:10.1080/0284186X.2018.1546057).
• Guo D, Li M, Chen D, ve ark. Neutrophil-to-lymphocyte ratio is superior to platelet-to-lymphocyte ratio as a prognostic predictor in advanced non-small-cell lung cancer treated with first-line platinum-based chemotherapy. Future Oncol. 2019;15(6):625-35. (doi:10.2217/fon-2018-0667).
• Minkov P, Gulubova M, Chilingirov P, Ananiev J. The Position of Neutrophils-To-Lymphocytes and Lymphocytes-To-Platelets Ratio as Predictive Markers of Progression and Prognosis in Patients with Non-Small Cell Lung Cancer. Open Access Maced J Med Sci. 2018;6(8):1382-6. (doi:10.3889/oamjms.2018.210).