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KMID : 1011820210620050545
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Investigative and Clinical Urology
2021 Volume.62 No. 5 p.545 ~ p.552
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The prognostic value of the pretreatment serum albumin to globulin ratio for predicting adverse pathology in patients undergoing radical prostatectomy for prostate cancer
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Chung Jae-Wook
Ha Yun-Sok
Kim Sang-Won
Park Seung-Chol
Kang Taek-Won
Jeong Young-Beom
Park Sung-Woo
Park Jin-Sung
Yoo Eun-Sang
Kwon Tae-Gyun
Seo Sung-Pil
Kang Ho-Won
Kim Won-Tae
Kim Yong-June
Lee Sang-Cheol
Kim Wun-Jae
Yun Seok-Joong
Kim Tae-Hwan
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Abstract
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Purpose: Few studies have demonstrated the clinical significance of pretreatment serum albumin and globulin in prostate cancer (PCa). This study evaluated the association between the pretreatment albumin to globulin ratio (AGR) and clinicopathologic characteristics of nonmetastatic PCa in a large multicenter setting in Korea.
Materials and Methods: This study involved 742 patients with nonmetastatic PCa who underwent radical prostatectomy (RP) in seven institutions between January 2011 and December 2012. The AGR was calculated as follows: albumin/(total protein?albumin). Patients were divided into low and high AGR groups by a cutoff value from a receiver operating characteristic curve analysis.
Results: The best cutoff for the AGR was set at 1.53. The area under the curve of the AGR was 0.624 (95% confidence interval, 0.557?0.671; p<0.001). Patients who had a lower pretreatment AGR (<1.53) were identified as the low AGR group (n=398, 53.6%) and the remaining patients as the high AGR group (n=344, 46.4%). Preoperative AGR was significantly lower in patients with non-organ-confined disease (≥pT3) than in those with organ-confined disease (≤pT2) (p<0.001). The low AGR group had higher aggressive pathologic Gleason scores (pGS) (≥8) than did the high AGR group (p=0.016). Furthermore, the AGR was an independent prognostic factor for high pGS (≥8) and non-organ-confined disease (≥pT3), according to multivariate logistic regression analysis.
Conclusions: A low AGR was closely associated with nonconfined disease (≥pT3) and high pGS (≥8). AGR can be a useful serological marker for predicting adverse pathology in patients with nonmetastatic PCa who undergo RP.
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KEYWORD
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Albumin, Globulin, Pathology, Prostate cancer, Prostatectomy
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