A novel inflammation-based prognostic index for patients with esophageal squamous cell carcinoma: Neutrophil lymphocyte ratio/prealbumin ratio.
Medicine
NLR/Alb (neutrophil lymphocyte ratio/albumin ratio), is a prognostic index for esophageal cancer has been confirmed. Prealbumin (PA) is more sensitive to malnutrition than albumin. A new prognostic index, named neutrophil lymphocyte ratio/prealbumin ratio (NLR/PA), for predicting the survival time in patients with esophageal squamous cell carcinoma (ESCC) was proposed.A retrospective study of 315 cases with ESCC was enrolled. The optimal cut-off values were evaluated by ROC curve (the receiver operating characteristics curve). Pearson correlation analyses were used to calculate the correlations among NLR, Alb, NLR/Alb and NLR/PA. The overall survival (OS) was calculated by Kaplan-Meier method. Cox regression analyses were performed to evaluate the prognostic factors.The optimal cut-off value was 0.01 for NLR/PA according to ROC curve. According to multivariate analyses, TNM stage, NLR, NLR/Alb, NLR/PA were prognostic factors for OS. The AUC area (the area under the receiver operating characteristics curves) of the NLR/PA was higher than the areas of NLR and NLR/Alb for all the patients. The index of NLR/ PA had a higher AUC area than that of the index of NLR or NLR/Alb for patients in stage I-II. But in stage III-IVA, the index of NLR had a higher AUC area than that of the index of NLR/PA or NLR/Alb.The index of NLR/PA is superior to the index of NLR as a prognostic indicator for patients with early stage (stage I-II) ESCC.
10.1097/MD.0000000000014562
Impact of prealbumin on mortality and hospital readmission in patients with acute heart failure.
Franco Jonathan,Formiga Francesc,Trullas Joan-Carles,Salamanca Bautista P,Conde Alicia,Manzano Luis,Quirós Raúl,Franco Álvaro González,Ezquerro Alejandro Martín,Montero-Pérez-Barquero Manuel,
European journal of internal medicine
BACKGROUND:Prealbumin is a maker of nutritional status and inflammation of potential prognostic value in acute heart failure (HF). The aim of this study is to evaluate if low prealbumin levels on admission predict mortality and readmissions in patients with acute HF. METHOD:We conducted a prospective observational cohort study including 442 patients hospitalized for acute HF. Patients were classified in two groups according to prealbumin levels: "normal" prealbumin (>15mg) and "low" prealbumin (≤15mg/dL). End-points were mortality and readmissions (all-cause and HF-related) and the combined end-point of mortality/readmission at 180days. RESULTS:Out of 442 patients, 159 (36%) had low and 283 (64%) had normal prealbumin levels Mean age was 79.6 (73.9-84.2, p=0,405) years and 183 (41%, p=0,482) were males. After a median 180days of follow-up, 108 (24%, p=0,021) patients died and 170 (38%, p=0,067) were readmitted. Mortality was higher in the low prealbumin group. The combined end-point was more frequent in the low prealbumin group (57% vs. 50%, p=0.199). In the multivariate analysis the following variables were associated with mortality or readmission: older age, exacerbated chronic HF, higher comorbidity, low systolic blood pressure and hemoglobin values and higher pro brain natriuretic peptide levels. CONCLUSIONS:Low prealbumin is common (36%) in patients with acute heart failure and it is associated with a higher short-term mortality.
10.1016/j.ejim.2017.05.009
Squamous cell carcinoma antigen, platelet distribution width, and prealbumin collectively as a marker of squamous cell cervical carcinoma.
Fu Shuang,Niu Ye,Zhang Xin,Zhang Ji-Rong,Liu Zhi-Ping,Wang Rui-Tao
Cancer biomarkers : section A of Disease markers
BACKGROUND:Squamous cell cervical carcinoma is the most common gynecological malignant disorder worldwide. Early detection of squamous cell cervical carcinoma is needed for proper clinical management. Squamous cell carcinoma antigen (SCCA) is commonly used as a tumor marker for squamous cell cervical carcinoma. Platelet distribution width (PDW) is an indicator of platelet activation. Prealbumin is a negative acute-phase protein. OBJECTIVE:The aim of this study was to investigate the ability of SCCA, PDW, and prealbumin individually or in combination, to distinguish between cervical carcinoma and control subjects. MEHTODS:Two hundred and twenty patients with squamous cell cervical carcinoma and 211 control subjects were included in the study. Patients' characteristics and hematologic tests data at initial diagnosis were collected. RESULTS:Our results showed that SCCA and PDW were higher, and prealbumin was lower in cervical carcinoma patients than in control subjects. Single biomarker had AUC value ranging from 0.753 for SCCA to 0.845 for PDW. The combination of SCCA and PDW increased the AUC to 0.900 (p< 0.0001). In addition, the combination of SCCA, PDW and prealbumin exhibited a significantly larger AUC of 0.917 (0.887-0.942), significantly higher than those of any single marker. CONCLUSIONS:The combined use of SCCA, PDW and prealbumin can accurately distinguish squamous cell cervical carcinoma from control subjects. This promising approach could be helpful in early detection of squamous cell cervical carcinoma.
10.3233/CBM-170442
Serum prealbumin and its changes over time are associated with mortality in acute kidney injury.
Wang Wenji,Pan Yu,Tang Xiao,Hao Guihua,Xie Yingxin,Ma Shuai,Luo Jianfeng,Guo Daqiao,Ding Feng
Scientific reports
Serum prealbumin is a clinically relevant indicator of nutritional status and inflammation in patients with acute kidney injury (AKI). This study aimed to determine whether serum prealbumin and its longitudinal changes over a week could improve the prediction of 90-day mortality in AKI patients. This prospective cohort study included 340 adults with AKI between 2014 and 2015. There were 94 (27.6%) patient deaths within 90 days. Serum prealbumin level <10 mg/dL at the time of AKI diagnosis was associated with a 155% increased death risk ratio (adjusted hazard ratio [HR], 2.55; 95% confidence interval [CI], 1.18 to 5.49; P = 0.02). Serum prealbumin fall >4 mg/dL was also associated with 90-day mortality in adjusted Cox regression models (HR, 1.79; 95% CI, 1.06 to 3.03; P = 0.03). Compared to serum albumin, mortality-predictability of serum prealbumin (P = 0.01) and its changes (P = 0.01) were both increased. Adding prealbumin and its changes on the conventional covariates improved the prediction of progression to 90-day mortality (NRI 0.29, P = 0.04; aIDI 0.08; P = 0.03). In conclusion, serum prealbumin, and its changes were independent predictors of worse prognosis in AKI, and could be potential surrogates to better predict 90-day mortality.
10.1038/srep41493
Role of Prealbumin as a Powerful and Simple Index for Predicting Postoperative Complications After Gastric Cancer Surgery.
Zhou J,Hiki N,Mine S,Kumagai K,Ida S,Jiang X,Nunobe S,Ohashi M,Sano T,Yamaguchi T
Annals of surgical oncology
BACKGROUND:Preoperative factors, including nutritional status, may have strong correlations with postoperative morbidities. The current study evaluated preoperative prealbumin concentrations as a predictor of postoperative complications after gastric surgery. METHODS:A retrospective study of 1798 patients who underwent gastrectomy for gastric adenocarcinoma was performed. Information was collected on basic patient characteristics, preoperative laboratory findings, and 30 day postoperative complications. The patients were divided into three groups based on prealbumin concentrations (≥22 mg/dL, <22 to ≥15 mg/dL, and <15 mg/dL) for analysis. RESULTS:The overall complication rate was 21.7 %, and the infection rate was 16 %. Subgroup analysis based on prealbumin concentrations showed that complication rates were markedly elevated with decreasing concentrations of prealbumin. Multivariate analysis using a logistic regression model showed that both overall and infectious complications were strongly associated with male gender, elevated C-reactive protein (CRP), and decreased prealbumin levels (p < 0.05). Even in patients with a CRP level higher than 0.1 mg/dL, male gender and low prealbumin concentrations (<15 mg/dL) were significantly correlated with overall and infectious morbidities (p < 0.05). CONCLUSIONS:Preoperative prealbumin concentrations are useful predictors of short-term postoperative outcomes after gastrectomy.
10.1245/s10434-016-5548-x
Serum prealbumin is an independent predictor of mortality in systemic sclerosis outpatients.
Codullo Veronica,Cereda Emanuele,Klersy Catherine,Cavazzana Ilaria,Alpini Claudia,Bonardi Chiara,Turri Annalisa,Franceschini Franco,Caccialanza Riccardo,Montecucco Carlomaurizio,Caporali Roberto
Rheumatology (Oxford, England)
OBJECTIVE:Serum prealbumin is a recognized marker of malnutrition, but its role in the prognosis of patients with SSc has not yet been investigated. The aim of the present multicentre prospective study was to investigate the association between prealbumin and mortality, independent of clinical features, in a cohort of SSc outpatients. METHODS:Patients were followed up according to standard clinical guidelines with visits at least every 6 months. Data collected included records of skin and internal organ involvement, survival and causes of death. RESULTS:During a median follow-up of 48 months [interquartile range (IQR) 25-58], 34/299 patients (11%) died. In univariable survival analysis, age; male sex; lung, gastrointestinal or multiple visceral organ involvement (two or more); co-morbidities (two or more) and low serum prealbumin were significant predictors of mortality. In bivariable Cox models, alternatively adjusted for significant predictors, prealbumin was independently and significantly associated with the outcome. Mortality rates were particularly influenced by low prealbumin in patients without significant co-morbidities or multiple organ involvement. CONCLUSION:In SSc patients, low serum prealbumin is an independent predictor of mortality, particularly in those without significant internal organ involvement. Further research on this nutritional marker is warranted.
10.1093/rheumatology/kev322
Serum Albumin and Prealbumin in Calorically Restricted, Nondiseased Individuals: A Systematic Review.
Lee Jessica L,Oh Esther S,Lee Rebecca W,Finucane Thomas E
The American journal of medicine
PURPOSE:Undernutrition is often suspected in patients when serum albumin or prealbumin levels are low. We asked whether these measures are indeed low in undernourished people if no inflammatory illness is present. METHODS:We did a systematic review to identify otherwise healthy subjects who were severely nutrient-deprived due to poor access to food or unwillingness to eat. We excluded children and pregnant women. We tabulated available measures of nutrient intake, anthropometry, serum albumin and prealbumin, and, when available, changes in these measures during nutritional intervention. RESULTS:In otherwise healthy subjects, serum albumin and prealbumin levels remained normal despite marked nutrient deprivation until the extremes of starvation, that is, body mass index <12 or more than 6 weeks of starvation. CONCLUSIONS:In these otherwise healthy subjects, serum albumin and prealbumin levels are not "markers of nutritional status." The "markers" failed to identify subjects with severe protein-calorie malnutrition until extreme starvation. That is, they failed to identify healthy individuals who would benefit from nutrition support, becoming abnormal only when starvation was already obvious. In contrast, serum albumin and prealbumin levels are known to fall promptly with injury or illness regardless of nutrient intake. They are negative acute-phase reactants. When these measures are low in sick patients, this cannot be assumed to reflect nutritional deprivation. Decisions about nutrition support should be based on evidence of meaningful benefit from this treatment rather than on assessment of "nutritional markers."
10.1016/j.amjmed.2015.03.032
CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial.
Lu Jun,Xu Bin-Bin,Zheng Zhi-Fang,Xie Jian-Wei,Wang Jia-Bin,Lin Jian-Xian,Chen Qi-Yue,Cao Long-Long,Lin Mi,Tu Ru-Hong,Huang Ze-Ning,Zheng Chao-Hui,Huang Chang-Ming,Li Ping
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
BACKGROUND:Serum prealbumin (PALB) can predict the prognosis of patients with gastric cancer (GC). However, the prognostic value of combination of C-reactive protein and PALB (CRP/PALB) remains unclear. METHODS:A total of 419 gastric cancer patients included in a clinical trial (NCT02327481) were analyzed. The present study is a substudy of the trial. Receiver operating characteristic (ROC) curves were generated, and by calculating the areas under the curve (AUC) and the C-index, the discriminative ability of each inflammatory index was compared, including CRP/PALB, C-reactive protein/albumin, Glasgow prognostic score (GPS), modified GPS, systemic immune-inflammation index, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio. RESULTS:Ultimately, 401 patients were included in this study. The optimal cutoff value of CRP/PALB was 17.7. According to this cutoff point, the entire sample was divided into a CRP/PALB < 17.7 (LCP) group and a CRP/PALB ≥ 17.7 (HCP) group, comprising 245 and 156 patients, respectively. There were 54 and 22 patients experienced recurrence in the HCP and LCP group, respectively, p < 0.001. Compared with traditional inflammatory indices, CRP/PALB had the highest AUC (0.707) and C-index (0.716), all p < 0.05. The post-recurrence survival (PRS) of patients in the HCP group was significantly shorter than that in the LCP group (p = 0.010), especially for pathological stage III patients (p = 0.015) or patients with distant (p = 0.018) or local (p = 0.023) recurrences. CONCLUSIONS:The predictive value of preoperative CRP/PALB for the recurrence of GC is significantly better than traditional inflammatory indices. HCP significantly reduces the PRS, especially for pathological stage III patients or patients with distant or local recurrences.
10.1007/s10120-018-0892-0