Prognostic Value of the Albumin-to-Globulin Ratio in Patients with Colorectal Cancer: A Meta-Analysis.

Recently, the albumin-to-globulin ratio (AGR) has been investigated as a prognostic parameter in patients with colorectal cancer (CRC); however, the results remain inconsistent. We aimed to quantitatively identify the prognostic role of the AGR in CRC through meta-analysis. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the prognostic value of the AGR for overall survival (OS), disease-free survival (DFS)/progression-free survival (PFS), and cancer-specific survival (CSS). The association between the AGR and clinicopathological factors was investigated using pooled odds ratios (ORs) and 95% CIs. Eleven studies, comprising 8,397 patients, were included in this meta-analysis. Our results demonstrated that a low AGR was significantly associated with poor OS (HR, 2.58; 95% CI, 1.90-3.51;  < 0.001) and poor DFS/PFS (HR, 2.11; 95% CI, 1.46-3.05;  < 0.001) in CRC. However, the AGR was not a significant prognostic factor for CSS (HR, 1.008; 95% CI, 0.372-2.730;  = 0.988). In addition, a low AGR was associated with patients aged ≥60 years (OR, 1.71; 95% CI, 1.54-1.89;  < 0.001). A low AGR was significantly associated with worse OS and inferior DFS/PFS in patients with CRC. Thus, AGR can be used as a cost-effective and reliable prognostic marker for CRC in clinical practice.