Az albumin prognosztikai jelentősége az onkológiában

Abstract

A szérumalbuminszint csökkenése figyelhető meg gyulladásos folyamatokban. A helyileg előrehaladott vagy áttétes rosszindulatú daganatokban a szérumalbuminszint ugyancsak csökken, az alultápláltság fennállásától függetlenül. A csökkent albuminszint befolyásolhatja a terápia eredményeit is (például gyógyszerek farmakokinetikája, mellékha-tások mértéke). Kiterjedt szakirodalmi adat és gyakorlati tapasztalat bizonyítja a táplálásterápiában részesülő pácien-sek jobb prognózisát. A szerzők a fontosabb szakirodalmi adatok alapján összefoglalják azon vizsgálatokat, melyek a kiindulási szérumalbuminszint és a rosszindulatú daganatos betegségek prognózisa közötti szoros összefüggést feltárták. Orv Hetil. 2018; 159(3): 96-106. Kulcsszavak: albumin, rosszindulatú daganatok, prognózis Prognostic importance of albumin in oncologyDiminished serum albumin level can be observed in inflammatory processes. Serum albumin level also reduces -irrespective of the presence of malnutrition -in locally advanced or metastatic malignancies. Low serum albumin level may have an influence also on the results of anticancer therapy (e.g., drug pharmacokinetics, adverse drug reactions). Extensive data of the literature and empirical experience prove the better prognosis of patients involved in nutritional therapy. Based on the most relevent data of the literature, the authors summarize the studies which have revealed the close correlation between the baseline serum albumin level and the prognosis of malignant diseases. Rövidítések ALI = (advanced lung cancer inflammation index) előrehala-dott tüdőrák index; APACHE = (acute physiology and chronic health evaluation) heveny élettani és idült egészség értékelés; BC = (breast cancer) emlőrák; BMI = (body mass index) testtömegindex (kg/m 2 ); CI = konfidenciaintervallum; CRC = (colorectal cancer) vastag-és végbélrák; CRP = C-reaktív protein; CRPC = (castration-resistant prostate cancer) kasztráció-rezisztens prostatarák; CSS = (cancer specific survival) daganatspecifikus túlélés; DFS = (disease-free survival) betegségmentes túlélés; DNS = dezoxiribonukleinsav; DSS = (disease-specific survival) betegségspecifikus túlélés; GPS = (Glasgow Prognostic Score) Glasgow prognosztikai pontrendszer; HCC = (hepatocellular carcinoma) primer májrák; HR = (hazard ratio) kockázati hányados; IL = interleukin; IMA = ischaemiamódosított albumin; IPI = (inflammatory prognostic index) gyulladásos prognosztikai index; KPS = Karnofsky Performance Status; LDH = (lactate dehydrogenase) laktátdehidrogenáz; LMR = (lymphocyte-monocyte ratio) abszolút lymphocyta-monocyta arány; mGPS = (modified Glasgow Prognostic Score) módosí-tott Glasgow prognosztikai pontrendszer; mGPS 0, 1, 2 = a módosított Glasgow prognosztikai pontrendszer értékei 0, 1, 2; MSKCC = Memorial Sloan Kettering Cancer Center; nabpaclitaxel = nanopartikuláris albuminhoz kötött paclitaxel; NLR = (neutrophil-lymphocyte ratio) abszolút neutrophillym phocyta arány; NRS = (nutritional risk screening) tápláltsá-gi kockázatszűrés; NSCLC = (non-small cell lung cancer) nem...

Overall Survival Prediction of Advanced Cancer Patients by Selection of the Most Significant Baseline Serum Biomarker Combination

“…Based on our results, we can confirm that a combination of biomarkers probably has a better prognostic value than any of the single biomarkers (Table 5). Other prognostic threshold values published in previous studies were comparable to our results (16,19,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45).…”

“…In a locally advanced and/or metastatic setting, serum albumin level diminishes independently in the presence of malnutrition. Lower baseline albumin suggests poor survival (19).…”

“…Both prospective and retrospective studies and also meta-analyses have described the poor prognostic role of elevated baseline C-reactive protein (CRP) (1)(2)(3)(4), crosslinked fibrin degradation products (D-dimer) (5)(6)(7)(8), lactate dehydrogenase (LDH) (9)(10)(11)(12), and decreased albumin (13)(14)(15) in cancer. Deme and Telekes have also reviewed the value of elevated CRP (16), D-dimer (17), LDH (18), and decreased albumin (19) for poor outcomes of cancer patients. Decreased lymphocyte to monocyte ratio (LMR) is a factor for adverse prognosis in several cancers (20)(21)(22)(23)(24).…”

Prognostic significance of preoperative prognostic nutritional index in ovarian cancer

“…The level of albumin can reveal the nutritional status of cancer patients, and low albumin level stands for the malnutrition of cancer patients, which can result in the poor prognosis and increase the cancer-related mortality. [ 23 , 24 ] A previous study containing 604 patients with OC showed low albumin was associated with higher complication rate and worse OS after the cytoreductive surgery. [ 25 ] On the other hand, it has already been proved that inflammation is associated with the proliferation, migration, immune escape, and chemoresistance of tumor cells.…”

Biomarkers of Inflammation and Progression During Immunotherapy in Patients With Metastatic Renal Cell Carcinoma

“…CRP and albumin represent acute phase reactants, although the concentrations move in opposite directions (21). The correlation of these acute phase reactants with neopterin concentrations, and the correlations between acute phase reactants or neopterin and hemoglobin concentration or platelet count have been amply documented in patients with solid tumors, as well as in patients with different nonmalignant conditions associated with inflammation (22)(23)(24)(25)(26).…”