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Decreased Average Albumin-to-Globulin Ratio During Radiotherapy Worsens the Prognosis of Esophageal Squamous Cell Carcinoma:Implications for Nutritional Management

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Journal of Nutritional Oncology 2021年第2期6卷 64-73页

作者： Fen Cai Xiu Lian Zhang Xiao Ling Wu Ting Ting Zhuang Lei Huang Yi Fei Tu Yuan Yuan Lu Min Xia Jiang Qing Ying Zhang Yan Lin Chang Chun Ma Department of Nosocomial Infection Management Cancer Hospital of Shantou University Medical CollegeShantou 515031GuangdongChina Department of Radiation Oncology Cancer Hospital of Shantou University Medical CollegeShantou 515031GuangdongChina Endoscope Room of the Clinic Cancer Hospital of Shantou University Medical CollegeShantou 515031GuangdongChina Department of Preventive Medicine Shantou University Medical CollegeShantou 515041GuangdongChina Department of Medical Imaging the Second Affiliated HospitalShantou University Medical CollegeShantou 515041GuangdongChina Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment Cancer Hospital of Shantou University Medical CollegeShantou 515031GuangdongChina

Objective malnutrition and cachexia are common in esophageal squamous cell carcinoma(ESCC)patients undergoing *** study evaluated how malnutrition-and cachexia-related indicators,including the albumin-to-globulin ratio(AGR),and their changes during radiotherapy predict the treatment *** We reviewed a total of 172 ESCC patients receiving radiotherapy(as a primary cohort)and performed a Cox regression analysis on potential prognostic factors,including the AGR,as well as the TNM stage and concomitant chemotherapy.A subsequent receiver operating characteristics(ROC)curve and Kaplan Meier survival analysis was performed for ESCC patients stratified by the average AGR cut-off *** In addition to the well-documented factors(*** stage and concomitant chemotherapy),the average AGR was a significant prognostic factor for ESCC patients receiving *** plotting the ROC curve of the average AGR with regard to the ESCC prognosis,we obtained cut-off points for the overall patients(cut-off point:1.5,AUC:0.636),for patients with stageⅡ/Ⅲdisease(cut-off point:1.5,AUC:0.611),and for patients with stageⅣdisease(cut-off point:1.84,AUC:0.900).The ESCC patients with higher average AGR had a significantly more favorable OS compared with those with a lower average ***,ESCC patients who had an increasingΔAGR during radiotherapy had a considerably more favorable OS compared with those with a decreasingΔ*** of these findings were reproducible in the validation *** A lower average AGR is indicative of a poorer prognosis for ESCC patients following *** the nutritional status and preventing or ameliorating cachexia might contribute to improving the prognosis of ESCC patients.

关键词： Esophageal carcinoma malnutrition and cachexia Albumin-to-globulin ratio Radiotherapy Prognosis

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