ALB and metastatic malignant neoplasm in the lymph nodes: Interestingly, Alessandro et al. demonstrated that increased preoperative CA19-9 levels (CA19-9 > = 32 U/ml) were significantly associated with pathological lymph node metastasis, and this ability was lost in the presence of hypoalbuminemia, suggesting that level of serum albumin affect the accuracy of preoperative CA19-9 levels in predicting oncological outcomes for patients with PDAC [27].