In this study, we aimed to analyze whether serum
prealbumin and
transferrin have a higher sensitivity than
albumin for detecting
malnutrition and predicting survival in
esophageal cancer patients. A total of 212 patients were prospectively enrolled.
Serum albumin,
prealbumin, and
transferrin were analyzed by
enzyme-linked
immunosorbent assays. The association of nutritional markers with survival was analyzed. We found that
malnutrition was presented in 44.5% of the patients, while 56.6% were unaware of their
body weight change. The area under the curve for diagnosing
malnutrition was largest for
prealbumin, followed by
transferrin and
albumin, with optimal breakpoints of 21 mg/dL, 206 mg/dL, and 4.3 g/dL, respectively, for diagnosing
malnutrition. The diagnostic sensitivity for
malnutrition was 34.1-63.4% with a single marker and this increased to 80.5% with all 3 markers. In patients with normal albuminemia (≥ 4.3 g/dL), a low level of
prealbumin and/or
transferrin predicted
malnutrition and poor prognosis. Multivariate Cox regression analysis confirmed that a low level of the nutritional marker was an independent poor prognostic factor. In conclusion, serum
prealbumin and
transferrin outperformed
albumin in identifying
esophageal cancer patients with
malnutrition and poor prognosis. Checking all three markers will help with the early diagnosis of
malnutrition and enable timely intervention.