Prognostic Value of the Preoperative Lymphocyte-to-C-Reactive Protein Ratio and Albumin-to-Globulin Ratio in Patients with Osteosarcoma

Figures & data

Table 1 Clinicopathological Characteristics of Patients

Variables	Cases	LCR			AGR			LMR			CAR
		<0.14	≥0.14	P-value	<1.79	≥1.79	P-value	<3.05	≥3.05	P-value	<0.24	≥0.24	P-value
Age				0.395			0.095			0.807			0.545
<18 years	55	15	40		38	17		28	27		30	25
≥18 years	82	28	54		45	37		40	42		49	33
Sex				0.280			0.587			0.654			0.314
Female	57	15	42		33	24		27	30		30	27
Male	80	28	52		50	30		41	39		49	31
Tumor site				0.821			0.037			0.190			0.403
Extremities	113	35	78		73	40		59	54		67	46
Non-extremities	24	8	16		10	14		9	15		12	12
Enneking stage				0.000			0.075			0.401			0.149
I/II	103	24	79		58	45		49	54		63	40
III	34	19	15		25	9		19	15		16	18
Neoadjuvant Chemotherapy				0.000			0.103			0.002			0.010
No	15	13	2		12	3		13	2		4	11
Yes	122	30	92		71	51		55	67		75	47
Pathological fracture				0.000			0.000			0.000			0.001
No	103	15	88		52	51		38	65		68	35
Yes	34	28	6		31	3		30	4		11	23
Local recurrence				0.000			0.112			0.000			0.002
No	113	24	89		65	48		48	65		72	41
Yes	24	19	5		18	6		20	4		7	17
Metastasis				0.000			0.000			0.001			0.004
No	76	12	64		36	40		28	48		52	24
Yes	61	31	30		47	14		40	21		27	34

Abbreviations: LCR, lymphocyte-to-C-reactive protein ratio; AGR, albumin‐to‐globulin ratio; LMR, lymphocyte–monocyte ratio; CAR, C-reactive protein to albumin ratio.

Figure 1 ROC curve analysis to evaluate the predictive value of preoperative (A) LCR, (B) AGR, (C) LMR and (D) CAR for OS in patients with osteosarcoma.

Abbreviations: ROC, receiver operating characteristic curves; LCR, lymphocyte-to-C-reactive protein ratio; AGR, albumin‐to‐globulin ratio; LMR, lymphocyte–monocyte ratio; CAR, C-reactive protein to albumin ratio; OS, overall survival.

Figure 2 Kaplan–Meier survival curves for OS in osteosarcoma patients according to (A) LCR, (B) AGR, (C) LMR and (D) CAR.

Abbreviations: OS, overall survival; LCR, lymphocyte-to-C-reactive protein ratio; AGR, albumin‐to‐globulin ratio; LMR, lymphocyte–monocyte ratio; CAR, C-reactive protein to albumin ratio.

Table 2 Univariate and Multivariate Cox Regression Analyses of Factors Associated with Overall Survival

Variables	Univariate Analysis			Multivariate Analysis
	HR	95% CI	P-value	HR	95% CI	P-value
Age			0.843
< 18 years
≥ 18 years	1.052	0.639–1.730
Sex			0.208
Female
Male	1.377	0.837–2.267
Tumor site			0.052
Extremities
Non-extremities	0.461	0.211–1.008
Enneking stage			0.051
I/II
III	1.660	0.998–2.759
Neoadjuvant chemotherapy			0.000			0.123
No
Yes	0.316	0.177–0.564		0.581	0.292–1.158
Pathological fracture			0.000			0.025
No
Yes	2.936	1.806–4.772		2.605	1.130–6.005
Local recurrence			0.020			0.346
No
Yes	1.917	1.106–3.324		1.346	0.726–2.496
Metastasis			0.000			0.000
No
Yes	3.735	2.225–6.271		2.876	1.608–5.147
LCR			0.000			0.012
< 0.14
≥ 0.14	0.266	0.164–0.434		0.349	0.154–0.791
AGR			0.000			0.001
< 1.79
≥ 1.79	0.317	0.179–0.564		0.351	0.184–0.668
LMR			0.010			0.342
< 3.05
≥ 3.05	0.523	0.319–0.856		0.748	0.412–1.361
CAR			0.004			0.838
< 0.24
≥ 0.24	2.044	1.263–3.307		1.065	0.583–1.944

Abbreviations: HR, hazard ratios; CI, confidence interval; LCR, lymphocyte-to-C-reactive protein ratio; AGR, albumin‐to‐globulin ratio; LMR, lymphocyte–monocyte ratio; CAR, C-reactive protein to albumin ratio.