Prognostic Value of Pretreatment Albumin to Globulin Ratio in Lung Cancer: A Meta-Analysis

Objective: To explore the predictive role of pretreatment albumin to globulin ratio (AGR) for prognosis in lung cancer.Methods: A comprehensive literature retrieval was performed in the PubMed, Cochrane Library, Web of Science and EMBASE databases up to May 20, 2019. The pooled hazard ratio (HR) and 95% confidence interval (CI) were applied to assess the correlation of pretreatment AGR with overall survival (OS) and disease-free survival (DFS). Sensitivity analysis was performed to assess the stability of results. Bess’s funnel plot and Egger’s test were conducted to detect potential publication bias.Results: Eight articles involving 3496 patients were included in our meta-analysis and all studies were from Asian countries. The results demonstrated that a low pretreatment AGR was significantly associated with poor OS (HR = 1.88, 95% CI: 1.49–2.38, P<0.001) and DFS (HR = 2.09, 95% CI: 1.56–2.81, P<0.001) and sensitivity analysis indicated the stability of above results. Publication bias test showed that there were two potentially unpublished articles, but they did not have a significant influence on the results of our meta-analysis.Conclusion: Our study manifested that pretreatment AGR was a reliable predictor for survival and it may contribute to the risk evaluation and therapy strategy formulation of lung cancer patients.