In terms of ALI, some studies reported that low ALI could serve as a predictor for worse outcomes in other malignancies.[27,28] Also, BMI and serum albumin level, which are the components of ALI, have been studied as prognostic factors for pancreatic cancer.[29,30] We hypothesized that ALI might be useful in identifying high-risk IPMNs, considering that BMI and NLR were also related to the invasiveness of IPMN. The gene discussed is ALB; the disease is familial pancreatic carcinoma.