Prognostic significance of preoperative albumin-to-globulin ratio and prognostic nutritional index combined score in Siewert type 3 adenocarcinoma of esophagogastric junction

Figures & data

Table 1 Univariate and multivariate analyses of the clinicopathological characteristics for overall survival in 215 patients with S3-AEG

Characteristics	Patients (%)	OS (months)	Univariate		Multivariate
[mean (95% CI)]	HR 95% CI	P-value	HR 95% CI	P-value
Age (years)			0.977 (0.701–1.363)	0.892
<62	98 (45.6%)	48.7 (37.8–59.6)
≥62	117 (54.4%)	50.1 (40.9–59.4)
Gender			1.231 (0.781–1.940)	0.371
Male	182 (84.7%)	50.6 (43.1–58.0)
Female	33 (15.3%)	53.7 (34.7–72.8)
Tumour size (cm)			1.473 (1.032–2.103)	0.033	0.969 (0.667–1.406)	0.867
<5.0	73 (34.0%)	57.6 (46.3–68.8)
≥5.0	142 (66.0%)	45.4 (36.9–53.8)
Differentiation			1.258 (0.903–1.751)	0.174
Poor	116 (54.0%)	44.2 (36.1–52.4)
Well	99 (46.0%)	55.3 (44.5–66.2)
Pathological T stage			1.512 (1.159–1.973)	0.002	0.843 (0.001–1.911)	0.957
T1	9 (4.2%)	98.4 (90.3–106.4)
T2	15 (7.0%)	65.7 (41.0–90.5)
T3	19 (8.8%)	30.5 (19.3–41.7)
T4	172 (80.0%)	46.3 (38.8–53.8)
Lymph node metastasis			0.411 (0.283–0.595)	<0.001	0.469 (0.320–0.688)	<0.001
Negative	81 (37.7%)	69.8 (58.8–80.8)
Positive	134 (62.3%)	37.8 (30.0–45.7)
pTNM stage			2.246 (1.571–3.209)	<0.001
I and II	87 (40.5%)	68.3 (17.7–118.9)
III	128 (59.5%)	18.7 (15.3–22.0)
AGR-PNI			0.637 (0.503–0.807)	<0.001	0.613 (0.226–0.923)	<0.001
0	39 (18.1%)	14.5 (9.8–19.3)
1	107 (49.8%)	28.3 (21.4–35.0)
2	69 (32.1%)	56.0 (23.6–89.6)
PLR			1.256 (0.905–1.742)	0.173
<130.8	107 (49.8%)	54.0 (43.9–64.0)
≥130.8	108 (50.2%)	46.2 (36.5–55.9)
NLR			1.118 (0.805–1.550)	0.506
<2.2	106 (49.3%)	51.9 (42.0–61.9)
≥2.2	109 (50.7%)	48.8 (38.9–58.7)

Abbreviations: pTNM, pathological tumour node metastasis; WBC, white blood cell; AGR, albumin-to-globulin ratio; PNI, prognostic nutritional index; PLR, platelet to lymphocyte ratio; NLR, neutrophil to lymphocyte ratio.

Figure 1 Receiver operating characteristic curve for the (A) albumin-to-globulin ratio and (B) prognostic nutritional index.

Figure 2 Kaplan-Meier overall survival curves of 5-year survival rates for 215 patients with S3-AEG undergoing curative resection stratified according to the AGR-PNI score. (A) Patients with either stage I, II or III S3-AEG. (B) Patients with stage I or II S3-AEG. (C) Patients with stage III S3-AEG. (D) Stage III S3-AEG patients with an AGR-PNI score of 2, and stage I + II S3-AEG patients with a AGR-PNI score of 0.

Table 2 Relationships between AGR-PNI and the clinicopathological characteristics of 215 S3-AEG patients

Characteristics	AGR-PNI			P-value
0	1	2
Age (years)				0.019
<62	16 (7.44%)	41 (19.07%)	41 (19.07%)
≥62	23 (10.70%)	66 (30.70%)	28 (13.02%)
Gender				0.056
Male	30 (13.95%)	88 (40.93%)	64 (29.77%)
Female	9 (4.19%)	19 (8.84%)	5 (2.32%)
Tumour size (cm)				0.016
<5.0	7 (3.26%)	35 (16.28%)	31 (14.42%)
≥5.0	32 (14.88%)	72 (33.49%)	38 (17.67%)
Differentiation				0.154
Poor	21 (9.77%)	64 (29.77%)	31 (14.42%)
Well	18 (8.37%)	43 (20.00%)	38 (17.67%)
T stage				0.871
T1	1 (0.46%)	5 (2.32%)	3 (1.39%)
T2	2 (0.94%)	7 (3.26%)	6 (2.79%)
T3	3 (1.39%)	12 (5.58%)	4 (1.86%)
T4	33 (15.35%)	83 (38.61%)	56 (26.05%)
Lymph node metastasis				0.625
Negative	13 (6.05%)	39 (18.14%)	29 (13.49%)
Positive	26 (12.09%)	68 (31.63%)	40 (18.60%)
pTNM stage				0.607
I and II	16 (7.44%)	40 (18.60%)	31 (14.42%)
III	23 (10.70%)	67 (31.17%)	38 (17.67%)
NLR				0.004
<2.2	10 (4.65%)	57 (26.51%)	39 (18.14%)
≥2.2	29 (13.49%)	50 (23.26%)	30 (13.95%)
PLR				0.032
<130.8	12 (5.58%)	58 (26.98%)	37 (17.21%)
≥130.8	27 (12.56%)	49 (22.79%)	32 (14.88%)

Abbreviations: pTNM, pathological tumour node metastasis; AGR, albumin-to-globulin ratio; PNI, prognostic nutritional index; PLR, platelet to lymphocyte ratio; NLR, neutrophil to lymphocyte ratio; S3-AEG, Siewert type 3 adenocarcinoma of esophagogastric junction.

Table 3 Area under the ROC curves of the tumour size and of the NLR, PLR, and AGR-PNI scores

Characteristics	Area under the ROC curve (95% CI)	P-value
Tumour size (cm)	0.551 (0.469–0.684)	0.220
NLR	0.510 (0.428–0.593)	0.803
PLR	0.539 (0.487–0.634)	0.112
AGR-PNI	0.653 (0.500–0.648)	<0.001

Note: Bold values in tables mean statistical significance.

Abbreviations: AGR, albumin-to-globulin ratio; PNI, prognostic nutritional index; ROC, receiver operating characteristic; PLR, platelet to lymphocyte ratio; NLR, neutrophil to lymphocyte ratio.

Figure 3 Area under the receiver operating characteristic curves of tumour size and of the NLR, PLR, and AGR-PNI scores.

Abbreviations: AGR, albumin-to-globulin ratio; PNI, prognostic nutritional index; PLR, platelet to lymphocyte ratio; NLR, neutrophil to lymphocyte ratio.