Abstract：Objective To evaluate the correlation of preoperative albuminglobulin ratio (AGR) with clinicopathological characteristics and prognosis of bladder cancer (BC) patients.Methods A comprehensive search was conducted in PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP database and Wanfang database for studies on the correlation between preoperative AGR and BC prognosis from the establishment of the database to July 20, 2022. NOS scale was used to evaluate the quality of the included literatures, and the relationship between AGR and the prognosis and clinicopathological features of BC patients was studied.Results A total of 8 articles were included in this study, including 1 716 patients with bladder cancer. The results showed that the preoperative AGR was significantly correlated with OS(HR=2.97，95%CI:1.38～6.40, P=0.005)、recurrence-free survival(RFS)(HR=3.33，95%CI:2.14～5.17, P<0.001)、CSS(HR=3.82，95%CI:2.07～7.07, P<0.001) and PFS(HR=3.72，95%CI:2.33～5.93，P<0.001).In addition, the differences between preoperative low AGR group and high AGR group in terms of age (OR=2.073，95%CI：1.454～2.955，P<0.001) ,tumor diameter(OR=1.691，95%CI：1.343～2.129, P<0.001), lymph node metastases (OR=3.060，95%CI：1.912～4.899，P<0.001）and musc-inrasive bladder cancer(MIBC)stage (OR=1.957，95%CI：1.018～3.763，P=0.044) were statistically significant.Conclusions Preoperative low level of AGR is significantly associated with poor survival outcome and poor pathological features in BC patients and AGR is expected to become a prognostic indicator of BC.
