Combination of Serum Albumin and Cholinesterase Levels as Prognostic Indicator in Patients ith Colorectal Cancer

Abstract

Background/aim: Nutritional status is strongly associated with cancer prognosis. The aim of this study was to identify the most useful combination of nutrition-related serum markers for predicting prognosis of patients with colorectal cancer (CRC).

Patients and methods: A total of 523 patients who underwent proctocolectomies for CRC at our hospital were enrolled in this study. Serum concentrations of albumin, cholinesterase and total cholesterol, and total peripheral lymphocyte count (TLC) were used as nutrition-related markers.

Results: In multivariate analysis of nutrition-related markers, serum albumin and cholinesterase levels were found to be independent prognostic indicators. Cut-off values from receiver operating characteristic analyses were used to sort patients as ChE^High or ChE^Low (serum cholinesterase level ≥ or <221.5), and as Alb^High or Alb^Low (serum albumin level ≥ or <3.85). We then sorted them into three groups: ChE^High/Alb^High (Group A); ChE^High/Alb^Low or ChE^Low/Alb^High (Group B); and ChE^Low/Alb^Low (Group C). Their 5-year overall survival rates differed significantly (Group A: 81.6%, Group B: 62.1%, Group C: 42.7%, p<0.0001); as did their 5-year disease-specific survival rates (Group A: 90.1%, Group B: 73.8%, Group C: 62.2%, p<0.0001).

Conclusion: The combination of serum cholinesterase and albumin levels is useful for predicting the prognosis of patients with CRC.

Keywords: Albumin; biomarker; cholinesterase; colorectal cancer; prognosis.