ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Experimental Pharmacology and Drug Discovery
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1556108
This article is part of the Research TopicAdvancing Glioma Treatment: Novel Drugs, Mechanisms of Resistance, and Therapeutic StrategiesView all 12 articles
Prognostic Value of the Pre-treatment Albumin-to-Alkaline Phosphatase Ratio in Patients with Lower-Grade Glioma: A Propensity Score Matching Study
Provisionally accepted
- 1Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, Shanghai Municipality, China
- 2National Center for Neurological Disorders, Shanghai, 200030, China, shanghai, China
- 3Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200030, China, shanghai, China
- 4Department of Neurosurgery, China-Japan Friendship Hospital, Beijin, China
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The albumin-to-alkaline phosphatase ratio (AAPR) has emerged as a novel prognostic predictor in various solid tumors. This study aimed to assess the prognostic significance of pre-treatment AAPR in patients with lower-grade glioma (LGG) through propensity score matching (PSM), Kaplan-Meier survival analysis, Cox regression analysis, and the development of a predictive nomogram. A total of 225 LGG patients were included in the analysis. Restricted cubic spline (RCS) analysis revealed a nonlinear relationship between AAPR and overall survival (OS) (p = 0.0349). Prognostic evaluation, stratifying patients based on the median AAPR value of 0.704, indicated that patients in the AAPR-High group (AAPR ≥ 0.704) experienced significantly favorable overall survival (log-rank p = 0.0042) and progression-free survival (PFS) (log-rank p = 0.042) compared to those in the AAPR-Low group (AAPR < 0.704). Furthermore, analysis stratified by various prognostic factors suggested that AAPR possesses greater predictive value in low-risk LGG patients. Univariate Cox analysis confirmed that higher AAPR levels were significantly associated with improved OS (p = 0.005, HR = 0.541, 95% CI: 0.353-0.829), while multivariate Cox analysis identified AAPR as an independent prognostic factor for OS (p = 0.046, HR = 0.630, 95% CI: 0.400-0.993). A nomogram incorporating AAPR and other prognostic factors demonstrated robust predictive accuracy for 1-year, 3-year, and 5-year OS, with validation in the PSM cohort. In conclusion, pre-treatment AAPR is a simple, convenient, and non-invasive biomarker with significant prognostic value for LGG patients.
Keywords: AAPR, LGG, biomarker, prognosis, Propensity score matching 1
Received: 06 Jan 2025; Accepted: 04 Jul 2025.
Copyright: © 2025 Xiaoming, Li and Zang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huang Xiaoming, Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, Shanghai Municipality, China
Lingjuan Li, Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, Shanghai Municipality, China
Di Zang, Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, Shanghai Municipality, China
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