A low albumin to globulin ratio with a high serum globulin level is a prognostic marker for poor survival in cervical cancer patients treated with radiation based therapy

Abstract

ObjectiveWe investigated whether the pretreatment albumin to globulin ratio, serum albumin level, and serum globulin level can be used to predict survival among cervical cancer patients treated with radiation based therapy and assessed globulin fractions.MethodsWe retrospectively enrolled 128 patients with cervical cancer treated with radiation based therapy at our institution between 2010 and 2015. The associations of the pretreatment albumin to globulin ratio, and serum albumin and globulin levels with overall survival were assessed. Additionally, the associations of the globulin fractions with the serum globulin levels and overall survival were evaluated.ResultsMedian follow-up duration was 30 months (IQR 16–44 months). A low albumin to globulin ratio (< 1.53) was found to be an independent prognostic factor for overall survival (HR= 3.07; 95% CI, 1.03 to 13.3; P=0.044). On evaluating serum globulin and albumin separately, a high serum globulin level was significantly associated with overall survival (cut-off value 2.9 g/dL; HR=3.74; 95% CI 1.08 to 23.6; P=0.036) whereas a low serum albumin level was not associated with overall survival (cut-off value 3.6 g/dL; HR=1.77; 95% CI 0.57 to 4.54; P=0.29). Electrophoresis data of the serum proteins revealed that the γ-globulin fraction was most strongly correlated with the globulin levels (P<0.001). Furthermore, a high γ-globulin level (≥1.28 g/dL) was significantly associated with poor overall survival (log rank test, P=0.034).ConclusionsA pretreatment low albumin to globulin ratio, which might be attributable to a high serum globulin level, can be used to predict poor prognosis in cervical cancer patients treated with radiation based therapy.

Serum Globulin and Albumin to Globulin Ratio as Potential Diagnostic Biomarkers for Periprosthetic Joint Infection: A Retrospective Review

“…Moreover, low A/G ratio is a useful marker to predict poor prognosis in cancer patients [16,21]. In cervical cancer, high globulin levels and low A/G ratio were linked with in ammation and poor prognosis [16]. In accordance with these results, we also observed that high globulin levels and low A/G ratio were independently associated with the risk of PJI and the associations remained signi cant even after accounting for demographic variables.…”

“…Similarly, Schmilovitz-Weiss et al reported that high serum globulin levels could serve as a marker to predict the extent of hepatic brosis in patients with post-transplant recurrent hepatitis C infection [13]. Moreover, low A/G ratio is a useful marker to predict poor prognosis in cancer patients [16,21]. In cervical cancer, high globulin levels and low A/G ratio were linked with in ammation and poor prognosis [16].…”

“…Another serum protein, albumin, has been reported to be negatively regulated by the acute phase reactant and is considered as a biomarker of in ammation and nutritional status [17,18]. Collectively, the inverse relationship between globulin and albumin in response to in ammation and infection functions to dramatically decrease the A/G ratio, suggesting that the A/G ratio is strongly representing the in ammatory status and infection of our body [16]. Therefore, we newly introduced globulin and A/G ratio, re ected the patient's in ammatory and infection status, as biomarkers of PJI.…”

“…Globulin, an easily accessible and reliable biomarker in the basic metabolic panel, has proven to be a critical marker associated with in ammation and infection [10]. Numerous studies have shown elevated serum globulin levels and decreased albumin to globulin (A/G) ratio in patients with infection and advanced malignancy, suggesting their important role in the immune and in ammatory system [11][12][13][14][15][16]. However, until now, no strong consensus focusing on the association between globulin, A/G ratio, and the development of PJI has been elucidated.…”

Monosodium Glutamate Plus Artemether-lumefantrine Overdose Altered Malondialdehyde, Total Protein and Albumin Concentration in Rats

“…Appropriate ratios of the studied bio-indicators could be prognostic [53].In the serum and liver homogenate of the rats, the total protein : albumin ratio was lower while the albumin : total protein ratio was higher, respectively in the rats exposed to MSG, Overdose of AL + MSG or overdose of AL when compared with the control. The observation could be a pointer to hitherto unknown underlying pathology as recently low albumin/globulin ratio was significantly associated with poor overall survival in various cancers [54] while a low albumin to globulin ratio was a prognostic marker for poor survival in cervical cancer patients [55]. Generally, the non-significant (P>0.05) and inconsistent responses in some groups, is not surprising.…”