Prognostic value of visceral protein ratios in patients with colon cancer

Abstract

This study aimed to assess different combinations of visceral proteins and to elucidate their value in predicting progression-free survival (PFS) and overall survival (OS) in patients with colon cancer. The visceral protein ratios included the albumin-globulin ratio (AGR), prealbumin-globulin ratio (PGR), and albumin-prealbumin-globulin ratio (APGR). Compared with AGR and PGR, APGR had the best time-dependent area under the receiver operating characteristic curves for predicting the outcomes. High AGR/PGR/APGR levels were associated with an increased risk of mortality. High AGR (HR = 0.816, 95%CI: 0.719–0.925, p = 0.001), PGR (HR = 0.831, 95%CI: 0.724–0.953, p = 0.008), and APGR (HR = 0.789, 95%CI: 0.688–0.904, p < 0.001) were independent risk factors for PFS. For every SD increase in AGR, PGR, and APGR, the risk of poor OS in patients with colon cancer was reduced by 16.9 % (HR = 0.831, 95%CI, 0.733–0.943; p = 0.001), 15.1 % (HR = 0.849, 95%CI, 0.739–0.976; p = 0.021), and 19.1 % (HR = 0.809, 95%CI, 0.705–0.928; p = 0.002), respectively. Logistic regression models showed that AGR, PGR, and APGR were independent factors that affected recurrence. Visceral protein ratios are independent predictors of PFS and OS. Compared to the existing visceral protein ratios (AGR and PGR), APGR is a more accurate and sensitive indicator for predicting the outcomes of patients with colon cancer.

Keywords

• Systemic inflammation
• Malnutrition
• Visceral protein ratios
• Colon cancer
• Prognostic