A meta-analysis of albumin, globulin, and albumin globulin ratios for predicting prognosis of cervical cancer.

Abstract

This study intends to investigate the performance of albumin, globulin, and albumin-globulin ratio (AGR) in predicting the prognosis of patients with cervical cancer. PubMed, Web of Science, Embase, and Cochrane Library databases were searched for relevant articles up to 1 March 2024. To elucidate the prognostic power of albumin, globulin, and AGR in cervical cancer patients, hazard ratios and 95% confidence intervals (CI) were computed. Subgroup analyses were performed to assess the association between albumin and the prognosis of cervical cancer patients. Ten studies involving 2394 cervical cancer patients were enrolled. Our results manifested that low albumin level was linked to poorer overall survival (OS) (hazard ratio = 2.01, 95% CI = 1.45-2.80, p  < 0.001), independent of progression-free survival (PFS), whereas high globulin and low AGR were not notably correlated with both OS and PFS. Subgroup analyses by tumor stages, and treatment measures noted that low albumin levels were linked to poorer OS in tumor stages I-II (hazard ratio = 1.96, 95% CI = 1.12-3.43, p  = 0.018), I-IV (hazard ratio = 1.96, 95% CI = 1.24-3.10, p  = 0.004), and IV (hazard ratio = 3.4, 95% CI = 1.39-8.29, p  = 0.007). Low albumin levels were associated with poorer OS in multifactorial analysis (hazard ratio = 1.94, 95% CI = 1.52-2.48, p  < 0.001) and survival curves (hazard ratio = 3.38, 95% CI = 1.94-5.88, p  < 0.001). In patients undergoing surgery only (hazard ratio = 2.32, 95% CI = 1.70-3.17, p  < 0.001) and those with radiotherapy (hazard ratio = 2.12, 95% CI = 1.41-3.2, p  < 0.001), low albumin levels were linked to poorer OS, but neither associated with PFS. Low albumin levels in cervical cancer patients are associated with poorer prognoses, and therefore can be viewed as a simple and economical prognostic index for cervical cancer.