术前白蛋白与球蛋白比值对喉鳞状细胞癌患者预后的评估价值

目的 探讨术前白蛋白与球蛋白比值（albumin/globulin ratio，AGR）对喉鳞状细胞癌患者预后的评估价值。 方法 回顾性分析2008年1月至2017年12月于广西医科大学附属肿瘤医院头颈外科行喉癌手术治疗的147例患者的临床资料。通过X-Tile软件计算AGR的最佳截断值，并根据最佳截断值分为高AGR组（AGR＞1.31，n=98）和低AGR组（AGR≤1.31，n=49），比较两组患者的临床病理特征及总生存期。结果 两组患者肿瘤部位分型、T分期、N分期、临床分期差异均有统计学意义（P＜0.05）；高AGR组3年、5年总生存率分别为88.5%、82.4%，低AGR组分别为70.1%、56.4%，生存曲线比较差异有统计学意义（χ²=16.639，P＜0.001）。单因素Cox回归显示，吸烟、肿瘤部位分型、组织学分级、T分期、N分期、临床分期、AGR与患者总生存期有关（P<0.05）；校正潜在的混杂因素后，多因素Cox回归显示AGR≤1.31是影响患者总生存期的独立危险因素（HR=2.098，95%CI：1.142~3.856，P=0.017）。结论 低AGR的喉鳞状细胞癌患者预后较差，AGR可作为预后评估的指标。

Prognostic value of preoperative albumin/globulin ratio in patients with laryngeal squamous cell carcinoma

Objective To investigate the prognostic value of preoperative albumin/globulin ratio （AGR） in the laryngeal squamous cell carcinoma patients after surgical resection. Methods The clinical data of 147 patients with laryngeal squamous cell carcinoma who underwent laryngeal cancer surgery in department of head and neck surgery of Guangxi Medical University Cancer Hospital from January 2008 to December 2017 were retrospectively analyzed. The cutoff value of AGR was calculated by X-Tile 3.6.1 software，and patients were divided into high AGR group（AGR>1.31，n=98） and low AGR group（AGR≤1.31，n=49） according to the cutoff value. The clinical pathological factors and overall surrival were compared between the two groups. Results  There were significant differences in the difference of tumor location classification，T stage，N stage and clinical stage between the two group patients（P<0.05）.  The 3，5 years overall survival rate of high AGR group were 88.5% and 82.4%，while the 3，5 years overall survival rate of low AGR group were 70.1% and 56.4%. The difference of the overall surrival curve between the two groups was statistically significant（χ²=16.639，P＜0.001）. Univariate Cox regression revealed that smoke，tumor location classification，histological grade，T stage，N stage，clinical stage and AGR level were correlated with patients′ overall survival （P<0.05）. After adjusting for potential confounding factors，Cox regression showed that AGR≤1.31 was an independent risk factor，which affected the overall survival of patients（HR=2.098，95%CI：1.142-3.856，P=0.017）. Conclusion AGR has a relationship with the prognosis of laryngeal sqllamous cell carcinoma and the prognosis of patient with low AGR is poor，which can be used as an indicator of prognosis.