On the other hand, cytokines like tumor necrosis factor (TNF) can increase the permeability of the blood vessel walls, thus promoting the loss of ALB from the circulation.31 Subsequent hypoalbuminemia has been demonstrated to be correlated with reduced survival of patients in different types of cancer.32, 33 With respect to pancreatic cancer, Siddiqui et al34 demonstrated that low serum ALB could independently predict poor survival of <6 months in pancreatic cancer patients. This evidence concerns the gene TNF and familial pancreatic carcinoma.