OncoTargets and Therapy (Dec 2020)

Prognostic Value of the Preoperative Lymphocyte-to-C-Reactive Protein Ratio and Albumin-to-Globulin Ratio in Patients with Osteosarcoma

  • Hu H,
  • Deng X,
  • Song Q,
  • Lv H,
  • Chen W,
  • Xing X,
  • Zhu J,
  • Tan Z,
  • Cheng X,
  • Wang B,
  • Shao Z,
  • Zhang Y

Journal volume & issue
Vol. Volume 13
pp. 12673 – 12681

Abstract

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Hongzhi Hu,1,2,* Xiangtian Deng,2,3,* Qingcheng Song,2,* Hongzhi Lv,2 Wei Chen,2 Xin Xing,2 Jian Zhu,2,3 Zhanchao Tan,2 Xiaodong Cheng,2 Baichuan Wang,1 Zengwu Shao,1 Yingze Zhang1,2 1Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, People’s Republic of China; 2Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijazhuang 050051, People’s Republic of China; 3School of Medicine, Nankai University, Tianjin 300071, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yingze Zhang; Zengwu Shao Tel +86 18533112888; 86 13971021748Email [email protected] [email protected]: Growing evidence indicates that preoperative biomarkers could be identified as independent prognostic factors in various cancers. The purpose of this study was to assess prognostic value of the preoperative lymphocyte-to-C-reactive protein ratio (LCR), albumin-to-globulin ratio (AGR), lymphocyte–monocyte ratio (LMR), and C-reactive protein to albumin ratio (CAR) in patients with osteosarcoma.Methods: A total of 137 osteosarcoma patients treated at our hospital between 2011 and 2019 were enrolled in the study. Patient demographics, clinical characteristics, and laboratory data were collected and analyzed. The optimal cutoff values of LCR, AGR, LMR, and CAR were assessed with receiver operating characteristic (ROC) analysis. Kaplan–Meier analysis was performed to estimate overall survival (OS). Univariate and multivariate Cox regression models were employed to determine the independent prognostic factors. The hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated to evaluate relative risk.Results: The optimal cutoff values of LCR, AGR, LMR, and CAR were 0.14, 1.79, 3.05 and 0.24, respectively. According to the univariate analysis, OS was remarkably associated with neoadjuvant chemotherapy (P < 0.001), pathological fracture (P < 0.001), local recurrence (P = 0.020), metastasis (P < 0.001), LCR (P = 0.035), AGR (P = 0.028), LMR (P = 0.010), and CAR (P = 0.004). In multivariate analyses, pathological fracture (P = 0.025), metastasis (P < 0.001), LCR (P = 0.012), and AGR (P = 0.001) were identified as independent risk predictors for OS.Conclusion: The present study provides new evidence that the preoperative LCR and AGR could serve as independent prognostic factors for patients with osteosarcoma. These findings will help physicians to stratify patients for appropriate treatment protocols and facilitate decision-making so as to improve the patients’ survival condition.Keywords: osteosarcoma, biomarker, albumin-to-globulin ratio, C-reactive protein, lymphocyte, prognosis

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