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Meta-Analysis
. 2022 Sep 29;23(19):11501.
doi: 10.3390/ijms231911501.

Prognostic Value of Albumin to Globulin Ratio in Non-Metastatic and Metastatic Prostate Cancer Patients: A Meta-Analysis and Systematic Review

Stefano Salciccia  1 , Marco Frisenda  1 , Giulio Bevilacqua  1 , Pietro Viscuso  1 , Paolo Casale  2 , Ettore De Berardinis  1 , Giovanni Battista Di Pierro  1 , Susanna Cattarino  1 , Gloria Giorgino  1 , Davide Rosati  1 , Francesco Del Giudice  1 , Alessandro Sciarra  1 , Gianna Mariotti  1 , Alessandro Gentilucci  1
Affiliations
Meta-Analysis

Prognostic Value of Albumin to Globulin Ratio in Non-Metastatic and Metastatic Prostate Cancer Patients: A Meta-Analysis and Systematic Review

Stefano Salciccia et al. Int J Mol Sci. .

Abstract

The aim of our meta-analysis is to analyze data available in the literature regarding a possible prognostic value of the albumin to globulin ratio (AGR) in prostate cancer (PC) patients. We distinguished our analysis in terms of PC staging, histologic aggressiveness, and risk of progression after treatments. A literature search process was performed (“prostatic cancer”, “albumin”, “globulin”, “albumin to globulin ratio”) following the PRISMA guidelines. In our meta-analysis, the pooled Event Rate (ER) estimate for each group of interest was calculated using a random effect model. Cases were distinguished in Low and High AGR groups based on an optimal cut-off value defined at ROC analysis. Four clinical trials were enclosed (sample size range from 214 to 6041 cases). The pooled Risk Difference for a non-organ confined PC between High AGR and Low AGR cases was −0.05 (95%CI: −0.12−0.01) with a very low rate of heterogeneity (I2 < 0.15%; p = 0.43) among studies (test of group differences p = 0.21). In non-metastatic PC cases, the pooled Risk Difference for biochemical progression (BCP) between High AGR and Low AGR cases was −0.05 (95%CI: −0.12−0.01) (I2 = 0.01%; p = 0.69) (test of group differences p = 0.12). In metastatic PC cases, AGR showed an independent significant (p < 0.01) predictive value either in terms of progression free survival (PFS) (Odds Ratio (OR): 0.642 (0.430−0.957)) or cancer specific survival (CSS) (OR: 0.412 (0.259−0.654)). Our meta-analysis showed homogeneous results supporting no significant predictive values for AGR in terms of staging, grading and biochemical progression in non-metastatic PC.

Keywords: albumin to globulin ratio; hormone therapy; meta-analysis; prostatic neoplasm; radical prostatectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for meta-analysis (PRISMA) [22].
Figure 2
Figure 2
Forrest plot assessing Risk Differences with 95% CI for: biochemical recurrence (BCR), non-organ confined PC (T stage), lymph node involvement (N stage) and ISUP grading 4–5 between High and Low AGR groups.
See this image and copyright information in PMC

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