A New Index AGR-PLR Score (APS) for Patients with Esophageal Squamous Cell Carcinoma Undergoing Radical Esophagectomy

Abstract

Purpose

Biomarkers of the systemic inflammatory response and nutritional-related indicators have been used to assess the host anti-tumor immune response and predict prognosis in esophageal squamous cell carcinoma (ESCC). However, a new indicator system combining platelet-to-lymphocyte ratio (PLR) and albumin-globulin ratio (AGR), AGR-PLR score (APS), has not yet been evaluated for the prognosis prediction among ESCC patients.

Methods

A retrospective analysis was performed, including 633 patients with ESCC, comprising 450 in the training cohort and 183 in the validation cohort.

Results

In this study, we found that the overall survival time among patients with an APS of 2 was significantly shorter than that among patients with an APS of 1, and the survival time of patients with an APS of 1 was significantly shorter than that of patients with an APS of 0. Multivariate analysis showed that the APS was an independent prognostic factor for patients with ESCC. The APS demonstrated better prognostic accuracy and effectiveness for ESCC patients than either PLR or AGR alone. In addition, a new prediction nomogram was established according to tumor grade, APS, and tumor, node, metastasis (TNM) stage. Compared with the traditional 8th version of TNM staging system, this nomogram demonstrated improved sensitivity and specificity for the prediction of 3- and 5-year survival.

Conclusion

APS is a novel independent prognostic indicator for the radical resection of ESCC and a potential biomarker for monitoring the therapeutic response.

Keywords:

• AGR
• ESCC
• nomogram
• prognosis
• PLR

Code Availability

The authors declare that all data and R scripts supporting the findings of this study are available from the corresponding author upon reasonable request.

Data Sharing Statement

The data used to support the findings of this study are available from the corresponding author upon request.

Ethics Statement

The study protocol was performed in accordance with the guidelines outlined in the Declaration of Helsinki. The Ethics Committee of the First Affiliated Hospital of Soochow University approved the study, and all participants signed informed consent statements.

Disclosure

The authors declare that they have no competing interests.