Hypoalbuminaemia and tumour prognosis
As a common complication in cancer , hypoalbuminaemia not only reflects the nutritional status of tumour patients and increases in the risk of oedema and infection but is also related to poor prognosis
Juan Du Suxia Luo MD Department of Oncology , Affiliated Tumor Hospital of Zhengzhou University ( Henan Cancer Hospital ), Zhengzhou , China
Hypoproteinaemia is not a disease , but the result of reduction of total plasma protein caused by “ insufficient protein intake , decreased synthesis , increased catabolism , excessive loss , and altered distribution ”. Cancer patients , due to the underlying disease , or chemo / radiotherapy , surgery and other treatments , often have dietary absorption disorders or impaired protein consumption . In addition , research shows that under the same circumstances , cancer patients will need 50 %– 100 % more nitrogen than non-tumour patients . 1 At the same time , as the disease progresses , tumour cytokines , such as TNF-α , IL-1 , IL-6 , and interferon , can lead to an increase of protein catabolism and decrease of anabolic then negative balance of nitrogen , accelerating the development of hypoproteinaemia . Therefore , hypoproteinaemia is a common complication in cancer patients .
Apart from reflecting the malnutrition of tumour patients , hypoalbuminaemia also has adverse effects on other aspects of the body . For example , polyserosal effusion due to reduction of vascular colloid osmotic pressure and multiple oedema will increase heart burden ; drainage of pleural fluid and ascites will further exacerbate protein loss ; gastrointestinal congestion and oedema will affect patients ’ digestive and absorption functions , with clinical presentation of nausea , poor appetite and anorexia ; the decrease of water content in the blood vessels increases the blood viscosity and the risk of venous thrombosis ; and the resultant decreased immunity increases the risk of inflammation and infection . In addition , hypoproteinaemia also changes the tissue distribution of high-
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