2026 年 34 巻 1 号 p. 15-20
Introduction: The albumin-to-globulin ratio (AGR) has been extensively studied as a predictor of the clinical outcomes of various tumors including gastric cancer (GC). Meanwhile, the predictive performance of the albumin-lymphocyte-globulin-C-reactive protein (ALGC) index has not yet been examined for GC. We investigated the clinical relevance of the preoperative ALGC index in patients undergoing curative surgery for GC, alongside the AGR and five other well-established inflammatory/nutritional parameters.
Methods: We included 157 consecutive patients undergoing R0/R1 gastrectomy for GC. We retrospectively assessed the associations of these preoperative laboratory data indices with clinicopathological characteristics, postoperative complications and survival outcomes, employing receiver operating characteristic (ROC) curves, logistic regression and the Cox proportional hazards model.
Results: With ROC curves, the preoperative ALGC index had the largest area under the curve among seven examined indices. The preoperative ALGC index was significantly related to postoperative complications and the association remained independent even in a multivariate model (odds ratio 0.847 per 1-unit increase, 95% confidence interval 0.694-0.979, P = 0.021), while the other six indices did not. In univariate survival analyses, the preoperative ALGC index showed significant correlations with both overall and relapse-free survivals. There were, however, no independent relationships of the ALGC index with survival outcomes on multivariate analysis.
Conclusions: A lower preoperative ALGC index independently predicted adverse short-term outcomes following gastrectomy for GC, demonstrating superior predictive accuracy compared to other established parameters. Risk stratification using the ALGC index may help identify patients at increased risk of postoperative morbidity and thereby support individualized treatment strategies.
