Albumin Levels before Therapy and Clinicopathological Parameters of Lung Cancer Patients

Downloads
Highlights
- A notable finding was the significant relationship between albumin levels and ECOG scores, emphasizing the potential of albumin as an indicator of functional status in lung cancer patients.
- The research provided a comprehensive analysis of the correlation between albumin levels and various clinicopathological conditions.
Background: Serum albumin levels provide an objective measure of malnutrition. Albumin plays crucial roles in maintaining intravascular oncotic pressure, facilitating substance transport, and acting as a free radical scavenger. The progression of tumors, including lung cancer, is closely associated with malnutrition and cancer-related inflammation, which suppress albumin synthesis. Therefore, albumin can serve as a biomarker for assessing lung cancer progression. Low albumin levels are linked to poor prognosis. Objective: The aim of this study was to examine the relationship between albumin levels and lung cancer. Material and Method: This study included 130 lung cancer patients who underwent albumin testing. A cross-sectional study was conducted using medical records of patients diagnosed with lung cancer from January 2023 to December 2023. Data were collected on various factors, including age, gender, smoking status, cancer history, clinical symptoms, histopathological type, cancer stage, EGFR mutation status, ECOG score, clinical pleural effusion, Visual Analog Scale (VAS), and Body Mass Index (BMI). Result: The study sample was predominantly male (71.5%), aged over 50 years (76.9%), and active smokers (34.6%). Common symptoms included cough (83.8%) and shortness of breath (72.3%), with pleural effusion present in 53.8%. The majority had a moderate VAS score (46.9%) and were classified as underweight based on BMI (54.6%). Most patients were at stage IVA (63.0%), had an ECOG score of 1 (43.8%), and were diagnosed with adenocarcinoma (73.8%). A significant relationship was found between ECOG scores and albumin levels, with 70.6% of hypoalbuminemic samples having an ECOG score of 3 (p < 0.005). Conclusion: A significant relationship was observed between albumin levels and ECOG scores in lung cancer patients.
Alifano, M., Daffré, E., Iannelli, A., et al. 2021. The reality of lung cancer paradox: The impact of body mass index on long-term survival of resected lung cancer. A French nationwide analysis from the epithor database. Cancers, 13(18): 4574. doi: 10.3390/cancers13184574.
Andarini, S., Syahruddin, E., Aditya, N., et al. 2023. Indonesian society of respirology (ISR) consensus statement on lung cancer screening and early detection in Indonesia. Jurnal Respirologi Indonesia, 43(2). doi: 10.36497/jri.v43i2.455.
Ang, L., Chan, C. P. Y., Yau, W. P., et al. 2020. Association between family history of lung cancer and lung cancer risk: a systematic review and meta-analysis. Lung Cancer, 148: 129–137. doi: 10.1016/j.lungcan.2020.08.012.
Chairudin, M. R., Marhana, I. A., Erawati, D. 2020. Profile of primary lung cancer patients receiving inpatient and outpatient care at Dr. Soetomo General Academic Hospital Surabaya. Jurnal Respirasi, 5(3): 65. doi: 10.20473/jr.v5-I.3.2019.65-71.
Chen, Y. M., Lai, C. H., Lin, C. Y., et al. 2021. Body mass index, weight loss, and mortality risk in advanced-stage non-small cell lung cancer patients: A focus on EGFR mutation. Nutrients, 13(11): 3761. doi: 10.3390/nu13113761.
Chowienczyk, S., Price, S., Hamilton, W. 2020. Changes in the presenting symptoms of lung cancer from 2000–2017: A serial cross-sectional study of observational records in UK primary care. British Journal of General Practice, 70(692): e193–e199. doi: 10.3399/bjgp20X708137.
Cordeiro, L. de A. F., Silva, T. H., de Oliveira, L. C., et al. 2020. Systemic inflammation and nutritional status in patients on palliative cancer care: A systematic review of observational studies. American Journal of Hospice and Palliative Medicine®, 37(7): 565–571. doi: 10.1177/1049909119886833.
Divisi, D., Zaccagna, G., De Vico, A., et al. 2020. Malignant pleural effusion in lung cancer: Focus on treatment—through a review of literature. Journal of Xiangya Medicine, 5: 28–28. doi: 10.21037/jxym-20-53.
Fan, Y., Jiang, Y., Gong, L., et al. 2023. Epidemiological and demographic drivers of lung cancer mortality from 1990 to 2019: Results from the global burden of disease study 2019. Frontiers in public health, 11: 1054200. doi: 10.3389/fpubh.2023.1054200.
Gondhowiardjo, S., Christina, N., Ganapati, N. P. D., et al. 2021. Five-year cancer epidemiology at the National Referral Hospital: Hospital-based cancer registry data in Indonesia. JCO Global Oncology, (7): 190–203. doi: 10.1200/GO.20.00155.
Goodrose-Flores, C., Bonn, S., Klasson, C., et al. 2022. Appetite in palliative cancer patients and its association with albumin, CRP and quality of life in men and women—cross-sectional data from the palliative D-study. Life, 12(5): 671. doi: 10.3390/life12050671.
Gupta, D., Lis, C. G. 2010. Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature. Nutrition journal, 9: 69. doi: 10.1186/1475-2891-9-69.
Guven, D. C., Sahin, T. K., Erul, E., et al. 2022. The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis. Frontiers in Molecular Biosciences, 9. doi: 10.3389/fmolb.2022.1039121.
Haam, J.-H., Kim, B. T., Kim, E. M., et al. 2023. Diagnosis of obesity: 2022 update of clinical practice guidelines for obesity by the Korean society for the study of obesity. Journal of Obesity & Metabolic Syndrome, 32(2): 121–129. doi: 10.7570/jomes23031.
IBM Corp. 2012. IBM SPSS statistics for Windows, version 21.0. Armonk, NY: IBM Corp. Available at: https://www.ibm.com/support/pages/spss-statistics-210-available-download
Kanwal, M., Ding, X.J., Cao, Y. 2017. Familial risk for lung cancer. Oncology letters, 13(2): 535–542. doi: 10.3892/ol.2016.5518.
Khasanah, N. A., Oktaviyanti, I. K., Yuliana, I. 2019. Relationship between smoking history and place of residence with cytopathological features of lung cancer. Homeostasis, 2(1). doi: 10.20527/ht.v2i1.433.
Kristina, S. A., Endarti, D., Sendjaya, N., et al. 2016. Estimating the burden of cancers attributable to smoking using disability adjusted life years in Indonesia. Asian Pacific Journal of Cancer Prevention, 17(3): 1577–1581. doi: 10.7314/APJCP.2016.17.3.1577.
Kwok, W. C., Ho, J. C. M., Tam, T. C. C., et al. 2022. Serum protein level as a predictor of therapeutic response and adverse effects associated with afatinib use. Journal of Thoracic Disease, 14(6): 1880–1889. doi: 10.21037/jtd-21-1649.
Lemjabbar-Alaoui, H., Hassan, O., Yang, Y. W., et al. 2015. Lung cancer: Biology and treatment options. Biochimica et Biophysica Acta (BBA) - Reviews on Cancer, 1856(2): 189–210. doi: 10.1016/j.bbcan.2015.08.002.
Liu, Z., Diao, Y., Li, X. 2022. Body mass index and serum markers associated with progression-free survival in lung cancer patients treated with immune checkpoint inhibitors. BMC Cancer, 22(1): 824. doi: 10.1186/s12885-022-09744-5.
Ministry of Health of The Republic of Indonesia. 2023. Decree of the Minister of Health of the Republic of Indonesia regarding national guidelines for medical services for lung cancer management. Available at: https://kemkes.go.id/id/pnpk-2023---tata-laksana-kanker-paru
Moujaess, E., Fakhoury, M., Assi, T., et al. 2017. The Therapeutic use of human albumin in cancer patients' management Critical Reviews in Oncology/Hematology, 120: 203–209. doi: 10.1016/j.critrevonc.2017.11.008.
Nazha, B., Moussaly, E., Zaarour, M., et al. 2015. Hypoalbuminemia in colorectal cancer prognosis: Nutritional marker or inflammatory surrogate?. World journal of gastrointestinal surgery, 7(12): 370–7. doi: 10.4240/wjgs.v7.i12.370.
Nguyen, H. V., Byeon, H. 2023. Prediction of ECOG performance status of lung cancer patients using LIME-based machine learning’, Mathematics, 11(10): 2354. doi: 10.3390/math11102354.
Nur I, I., Susilawati, S., Fertilita, S. 2023. Association between patient characteristics and histopathological features of lung cancer at RSUP Dr. Mohammad Hoesin Palembang. Biomedical Journal of Indonesia, 9(2): 19–25. doi: 10.32539/bji.v9i2.149.
Pakzad, R., Mohammadian-Hafshejani, A., Ghoncheh, M., et al. 2015. The incidence and mortality of lung cancer and their relationship to development in Asia. Translational Lung Cancer Research, 4(6): 763–74. doi: 10.3978/j.issn.2218-6751.2015.12.01.
Peng, P., Yang, Y.,Du, J., et al. 2022. Prognostic biomarkers of malignant patients with pleural effusion: A systematic review and meta-analysis. Cancer Cell International, 22(1): 99. doi: 10.1186/s12935-022-02518-w.
Psallidas, I., Kalomenidis, I., Porcel, J. M., et al. 2016. Malignant pleural effusion: From bench to bedside. European Respiratory Review, 25(140): 189–198. doi: 10.1183/16000617.0019-2016.
Rajdev, K., Siddiqui, A. H., Ibrahim, U., et al. 2018. An unusually aggressive large cell carcinoma of the lung: Undiagnosed until autopsy. Cureus. doi: 10.7759/cureus.2202.
Ruano-Raviña, A., Provencio, M., Calvo de Juan, V., et al. 2020. Lung cancer symptoms at diagnosis: Results of a nationwide registry study. ESMO Open, 5(6): e001021. doi: 10.1136/esmoopen-2020-001021.
Sehgal, K., Gill, R. R., Widick, P., et al. 2021. Association of performance status with survival in patients with advanced non–small cell lung cancer treated with pembrolizumab monotherapy. JAMA Network Open, 4(2): e2037120. doi: 10.1001/jamanetworkopen.2020.37120.
Setyawan, U. A., Yudhanto, H. S., Madarina, A. 2022. One year survival of wild-type adenocarcinoma lung cancer patients receiving chemotherapy at dr. Saiful Anwar Hospital, Malang. Respiratory Science, 2(3): 148–155. doi: 10.36497/respirsci.v2i3.47.
Singh, B., Rao, R. 2022. Albumin and its association with lung cancer: An Indian perspective. Journal of Medical and Scientific Research, 10(4): 201–205. doi: 10.17727/JMSR.2022/10-37.
Stares, M., Swan, A., Cumming, K., et al. 2021. Hypoalbuminaemia as a prognostic biomarker of first-line treatment resistance in metastatic non-small cell lung cancer. Frontiers in Nutrition, 8. doi: 10.3389/fnut.2021.734735.
Tang, M., Lee, H. W., Weng, M. W., et al. 2022. DNA damage, DNA repair and carcinogenicity: Tobacco smoke versus electronic cigarette aerosol. Mutation Research/Reviews in Mutation Research, 789: 108409. doi: 10.1016/j.mrrev.2021.108409.
Thandra, K. C., Barsouk, A., Saginala, K., et al. 2021. Epidemiology of lung cancer. Współczesna Onkologia, 25(1): 45–52. doi: 10.5114/wo.2021.103829.
Travis. 2020. Lung cancer pathology. Clinics in Chest Medicine, 41(1): 67-85. doi: 10.1016/j.ccm.2019.11.001.
Walter, F. M., Rubin, G., Bankhead, C., et al. 2015. Symptoms and other factors associated with time to diagnosis and stage of lung cancer: A prospective cohort study. British Journal of Cancer, 112(S1): S6–S13. doi: 10.1038/bjc.2015.30.
Wang, X., Han, H., Duan, Q., et al. 2014. Changes of serum albumin level and systemic inflammatory response in inoperable non-small cell lung cancer patients after chemotherapy. Journal of Cancer Research and Therapeutics, 10(4): 1019. doi: 10.4103/0973-1482.137953.
Xie, C., Chen, J., Chen, Z., et al. 2023. Assessment of albumin and overall survival in advanced non-small cell lung cancer patients with anlotinib treatment using generalized additive model: A retrospective cohort study. Clinical eHealth, 6: 121–129. doi: 10.1016/j.ceh.2023.09.003.
Yoon, H.-S., Shu, X. O., Shidal, C., et al. 2022. Associations of pre-diagnostic serum levels of total bilirubin and albumin with lung cancer risk: Results from the southern community cohort study. Frontiers in Oncology, 12. doi: 10.3389/fonc.2022.895479.
Zhang, C., Gao, M. Q., Jiang, X. C., et al. 2023. Research progress and value of albumin-related inflammatory markers in the prognosis of non-small cell lung cancer: A review of clinical evidence. Annals of Medicine, 55(1): 1294–1307. doi: 10.1080/07853890.2023.2192047.
Zhang, T., Chen, X., Wan, B., et al. 2021. Development of RECLS score to predict survival in lung cancer patients with malignant pleural effusion. Translational Lung Cancer Research, 10(3): 1318–1326. doi: 10.21037/tlcr-20-1191.
Zhang, X., Xing, P., Hao, X., et al. 2021. Clinical value of serum albumin level in patients with non-small cell lung cancer and anaplastic lymphoma kinase (ALK) rearrangement. Annals of Palliative Medicine, 10(12): 12403–12411. doi: 10.21037/apm-21-3379.
Zheng, M. 2016. Classification and pathology of lung cancer. Surgical Oncology Clinics of North America, 25(3): 447–468. doi: 10.1016/j.soc.2016.02.003.
Copyright (c) 2025 Nor Fiayanti Hadiani, Erna Kusumawardhani

This work is licensed under a Creative Commons Attribution 4.0 International License.
1. The journal allows the author(s) to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution 4.0 International License (CC-BY).