title: Elevated pretreatment serum globulin albumin ratio predicts poor prognosis for advanced non-small cell lung cancer patients.
abstract: BACKGROUND
  The aim of the present study was to explore the association between the pretreatment globulin albumin ratio (GAR) and the survival of advanced non-small cell lung cancer (NSCLC) patients.
  
  
  METHODS
  Patients hospitalized between January 2007 and December 2010 were enrolled and eliminated according to the inclusion and exclusion criteria. GAR was defined as the absolute globulin value divided by the absolute albumin value. Chi-squared test was performed to compare clinical characteristics in different groups. Kaplan-Meier and Cox regression model were used to determine independent prognostic factors. A P value of ≤0.05 was considered to be statistically significant.
  
  
  RESULTS
  Total 316 patients were finally enrolled. The median progression free survival (PFS) and overall survival (OS) were 210.0 and 430.0 days, respectively. The statistical analyses indicated that pretreatment GAR >0.58 [hazard ratio (HR) =1.52, 95% confidence interval (95% CI): 1.12-2.08, P=0.008 for PFS, HR =1.65, 95% CI: 1.20-2.26, P=0.002 for OS], and pretreatment albumin ≤35 g/L (HR =2.09, 95% CI: 1.20-3.65, P=0.003 for PFS, HR =1.92, 95% CI: 1.10-3.36, P=0.022 for OS) were independent prognostic factors for both PFS and OS.
  
  
  CONCLUSIONS
  Our study first established a connection between pretreatment GAR and advanced NSCLC patients, suggesting that GAR was an independent prognostic factor and could be the biomarker for prognosis.
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Yanwen
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Yuan
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Hongbing
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Song
keywords: Globulin albumin ratio (GAR); non-small cell lung cancer (NSCLC); prognostic factor