Clinical impact of serum prealbumin in pancreaticobiliary disease

Abstract

Purpose: Although there are many studies on prealbumin in individual diseases such as malignant or inflammatory diseases, there are few comparative studies. This study aimed to compare the clinical differences between prealbumin levels in cholecystitis and pancreaticobiliary malignancies and investigate the clinical impact of low prealbumin levels in pancreaticobiliary malignancies.Methods: From June 2021 to September 2021, 61 patients who had undergone surgery for various pancreaticobiliary diseases were enrolled in this study, and their clinicopathological data were retrospectively analyzed.Results: Many elderly patients with malignant diseases had poor American Society of Anesthesiologists (ASA) scores, significantly lower albumin and prealbumin levels, and higher systemic immune inflammation indices. The low prealbumin group was older; had poorer ASA scores; and had significantly lower body mass index and hemoglobin and albumin levels and higher systemic immune inflammation indices than the normal prealbumin group. In malignant diseases, the low prealbumin group had significantly lower body mass index and hemoglobin levels and a tendency toward more advanced disease (lymph node and distant metastasis).Conclusion: Preoperative low prealbumin levels had an area under the receiver operator characteristic curve of 0.69, suggesting that it may be useful for predicting pancreaticobiliary malignancies. Prealbumin levels were lower in malignant diseases, possibly related to poor nutritional status and systemic immune inflammation. Low prealbumin levels may predict the risk of more advanced disease.

Clinical significance of C-reactive protein-to-prealbumin ratio in predicting early recurrence in resectable pancreatic cancer

“…Recent studies have reported that prealbumin is superior to albumin and an independent predictor in cancer patients [ 24 – 26 ]. In our previous study, we found that preoperative low prealbumin levels predicted advanced disease while confirming poor nutritional status in patients with low body mass index and hemoglobin levels who had hepatobiliary pancreatic malignant disease [ 27 ]. Based on these findings, the combination of CRP and prealbumin may prove to be a useful biomarker for predicting recurrence and prognosis, but its prognostic value has not yet been elucidated in PDAC patients.…”

Inflammatory and nutritional markers in patients with resectable pancreatic cancer

“…Since Virchow first described the interaction between inflammation and malignancy, CRP which is one of the inflammatory indicators has been reported as prognostic factors in various cancers [ 2 ]. Additionally, nutritional status such as serum albumin, and prealbumin has been found to be correlated with the prognosis of various malignancies, including pancreatic cancer [ 1 , 3 , 4 ]. Albumin, the most abundant protein in the human serum, serves as a valuable indicator of nutritional status.…”

“…Its hepatic synthesis is affected by osmotic colloid pressure and inflammatory states, but also, by nutritional status and hormones [ 5 ]. In patients with cancer, serum albumin has been found to be an independent prognostic factor for survival in various cancers such as melanoma, colorectal, pancreatic, lung, gastric, and breast cancer [ 3 , 5 – 7 ]. Furthermore, prealbumin has a shorter half-life which is about 2 to 3 days, and is considered more sensitive and accurate biomarker than albumin.…”

“…Furthermore, prealbumin has a shorter half-life which is about 2 to 3 days, and is considered more sensitive and accurate biomarker than albumin. Recent studies have reported that prealbumin is an independent predictor in cancer patients [ 3 ].…”