| ObjectiveA retrospective analysis of 208 patients with ovarian high-grade serous carcinoma who were treated in our hospital was performed to explore the effects of serum albumin and albumin-to-globulin ratio before treatment on their OS,PFS,3-year survival and recurrence.MethodsPatients which were pathologically diagnosed with high-grade serous ovarian cancer were collected from the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Nanchang University from November 2013 to August 2020.Recording the patients’ age,albumin-to-globulin ratio,serum albumin,CA125,FIGO stage,ascites and lymph node metastasis and following up the recurrence,survival,and platinum sensitivity of the patients.Patients aged ≥ 60 years with albumin less than34g/L or patients < 60 years old with albumin less than 35g/L were classified as low albumin group,and albumin-to-globulin ratio less than 1.50 as low albumin-to-globulin ratio group.To explore the correlation of different groups with age,stage,presence of ascites and other clinical data,as well as their effects on OS,PFS,3-year recurrence and survival in patients with high-grade serous ovarian cancer.Results1.Statistical grouping results:age ≥ 50 years vs age < 50 years(143 cases vs 65 cases),CA125 before treatment normal group vs abnormal group(27 cases vs 181 cases),FIGO stage I-II group vs IIIIV group(66 cases vs 142 cases),Preoperative lymph node metastasis group vs no lymph node metastasis group(62 cases vs 146 cases),ascites group vs no ascites group(124 cases vs 84 cases),normal albumin group vs decreased group(164 cases vs 44cases),recurrence group vs non-recurrence group(71 cases vs 137 cases),death group vs survival group(79 cases vs 129 cases),decreased albumin-to-globulin ratio group vs normal group(131 cases vs 77 cases),platinum chemotherapy-sensitive group vs resistant group(177 cases vs 31 cases),CA125 after treatment or after 6 courses of chemotherapy normal group vs abnormal group(171 cases vs 37 cases),3-year recurrence group vs non-recurrence group(68 cases vs 76 cases),3-year death group vs survival group(75 cases vs 69 cases).2.Correlation analysis results of albumin,albumin-to-globulin ratio and clinicopat hological data:There were no significant difference between albumin with age ≥50 years and age<50 years(P=0.927),CA125 normal group and abnormal group before treatment(P=0.171),CA125 normal group and abnormal group after treatment or after 6 courses of chemotherapy(P=0.326)(P>0.05);While there were statistically significant differences between albumin with FIGO stage I-II group and III-IV group(P=0.011),lymph node metastasis group and no lymph node metastasis group(P<0.001),ascites and no ascites group(P=0.003),decreased albumin-to-globulin ratio group and the normal group(P<0.001),platinum chemotherapy-sensitive group and the drugresistant group(P=0.002)(P<0.05).There were no significant difference between albumin-to-globulin ratio with age≥50 years and age <50 years(P=0.223),FIGO stage I-II group and III-IV group(P=0.086),platinum chemotherapy sensitive group and drug resistant group(P=0.071)(P>0.05);While there were statistically significant differences between albumin-toglobulin ratio with CA125 normal group and abnormal group before treatment(P=0.003),ascites group and no ascites group(P=0.018),lymph node metastasis group and no lymph node metastasis group(P=0.013),the CA125 end of treatment or After6 courses of chemotherapy normal group and abnormal group(P=0.015)(P<0.05).Multivariate Logistic regression analysis of factors affecting albumin-to-globulin ratio found that in low albumin,age ≥50 years,FIGO stage III-IV,lymph node metastasis,and ascites,Only low albumin(P=0.001)was an independent factor affecting low albumin-to-globulin ratio.3.The relationship between albumin,albumin-to-globulin ratio and prognosis of patients with HGSOC,the results show:The median PFS(12.9 months vs 15.6 months,HR=1.750,P=0.033,95%CL1.039～2.948)and median OS(27.3 months vs 30.8 months,HR=1.910,P=0.008,95%CL1.171～3.113)of the low albumin group of HGSOC patients were lower than those of normal albumin group,the difference was statistically significant(P<0.05).The median PFS(13.3 months vs 22.0 months,HR=0.584,P=0.035,95%CL0.353～0.969)andmedian OS(26.1monthsvs37.4months,HR=0.556,P=0.016,95%CL0.343～0.902)of HGSOC patients in the low albumin-to-globulin ratio group were lower than those in the normal albumin-to-globulin ratio group,the difference was statistically significant(P<0.05).HGSOC patients with low albumin-to-globulin ratio group(<1.5)vs normal albumin-to-globulin ratio group: recurrence vs no recurrence within 3 years(P=0.005),survival vs death(P=0.001),the differences were statistically significant(P< 0.05)There were no statistical significance between albumin with recurrence(P=0.337)and survival(P=0.130)within 3 years.4.The relationship between other clinicopathological data and the prognosis of HGSOC patients showed that:Abnormal CA125 before treatment(P=0.002),FIGO stage III-IV(P<0.001),lymph node metastasis(P=0.011),ascites(P<0.001),platinum resistance(P<0.001),recurrence(P<0.001)were risk factors for OS in patients with HGSOC,while age ≥50years(P=0.132)was not a risk factor for OS in patients with HGSOC.Age ≥50 years old(P=0.023),abnormal CA125 before treatment(P=0.004),FIGO stage III-IV(P<0.001),lymph node metastasis(P=0.019),ascites(P<0.001),platinum resistance drugs(P<0.001),abnormal CA125 after treatment or after 6 courses of chemotherapy(P<0.001)were all risk factors for PFS in patients with HGSOC.Abnormal CA125 before treatment(P=0.001),FIGO stage III-IV(P=0.001),and ascites(P<0.001)were the risk factors for recurrence within 3 years in patients with HGSOC,while age ≥50 years(P=0.126),Lymph node metastasis(P=0.087)were not risk factors for 3-year recurrence in HGSO patients.Abnormal CA125 before treatment(P<0.001),FIGO stage III-IV(P<0.001),lymph node metastasis(P=0.020),ascites(P<0.001),platinum resistance(P<0.001),recurrence(P<0.001),abnormal CA125 at the end of treatment or after six courses of chemotherapy(P=0.002)were risk factors for death within 3 years in patients with HGSO,while age ≥50 years(P=0.216)was not a risk factor for death within 3 years in patients with HGSO.5.The multivariate analysis that affects the prognosis of HGSOC patients shows that:FIGO stage III-IV(P=0.010,95%CL1.229～4.453),low albumin-to-globulin ratio(<1.5)(P=0.039,95%CL1.029～2.919),recurrence(P<0.001,95%CL11.872～60.317),and platinum resistance(P<0.001,95%CL1.817～5.117)were all independent risk factors for OS in HGSOC patients.Platinum resistance(P<0.001,95%CL1.217～4.9041),ascites(P=0.003,95%CL1.417～5.756),abnormal CA125 at the end of treatment or after 6 courses of chemotherapy(P=0.012,95%CL2.362～8.617)were independent risk factors for PFS in patients with HGSOC.Albumin-to-globulin ratio <1.5(P=0.031)was an independent risk factor for recurrence in HGSOC patients within 3 years,while abnormal CA125 before treatment(P=0.080),FIGO stage III-IV(P=0.151),and ascites(P=0.339)were non-independent risk factors.Ascites(P=0.032),albumin-to-globulin ratio <1.5(P=0.008),platinum resistance(P=0.023),FIGO stage III-IV(P=0.034)were independent risk factors for death within3 years of HGSO patients,while Lymph node metastasis(P=0.816),abnormal CA125 after treatment or after six courses of chemotherapy(P=0.282)were non-independent risk factors.Conclusions1.Low albumin is an independent factor leading to the decrease of albumin-toglobulin ratio in HGSOC patients.2.The levels of serum albumin and albumin-to-globulin ratio before treatment are related to the prognosis of HGSOC patients.Low albumin is a non-independent risk factor for OS and PFS in HGSOC patients.Low albumin-to-globulin ratio is an independent risk factor for OS,3-year recurrence and death in HGSOC patients.And independent risk factors for PFS in patients.Compared with albumin,the albumin-toglobulin ratio has a greater impact on the prognosis of HGSOC patients. |
PDF Full Text Request