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Correlation between Preoperative Serum Albumin-Globulin Ratio and Prognosis of Patients Undergoing Low Rectal Cancer Surgery by Guihong Rong, Shanshan Liu, Chunfeng Xi, Caimei Wang, Jinhuan Deng, Tao Qin

Background: To explore the correlation between preoperative serum albumin-globulin ratio (AGR) and the prognosis of patients undergoing low rectal cancer surgery.
Methods: A total of 152 patients treated from June 2013 to June 2015 were selected. They were divided into survival group (n = 128) and death group (n = 24). Their general clinical data and preoperative and postoperative serum albumin (ALB), globulin (GLB) levels, and AGR were compared. Multivariate logistic regression analysis was performed for influencing factors for postoperative death. A nomogram prediction model was established based on independent risk factors. The predictive value of AGR for clinical outcomes was analyzed by receiver operating characteristic (ROC) curve, and the optimal cut-off value was obtained. The correlation between AGR and postoperative clinical outcomes was analyzed. The patients were divided into group A and B according to cut-off value, survival curves were plotted by Kaplan-Meier method, and 5-year survival rates were compared.
Results: There were significant differences in tumor stage, cell differentiation, depth of tumor invasion, lymph node metastasis, chemotherapy, preoperative ALB, GLB, and AGR between the two groups, which were all independent risk factors for death. After operation, ALB and AGR significantly declined and were significantly lower in the death group than those in the survival group. The death group had significantly higher GLB level than that of the survival group. The optimal cut-off value of AGR for predicting death was 1.73. AGR was significantly correlated with postoperative clinical outcomes. The survival rate of patients with AGR > 1.73 significantly exceeded that of cases with AGR ≤ 1.73.
Conclusions: The preoperative serum AGR is an independent risk factor for the postoperative clinical outcomes of patients with low rectal cancer and has a high predictive value. Lower AGR indicates higher risk of postoperative death.

DOI: 10.7754/Clin.Lab.2021.210213