ALB and malnutrition: Given that malnutrition is a known risk factor for poor prognosis of dCCA, and that serum albumin is a key laboratory indicator of nutritional status, researchers also evaluated and confirmed the prognostic value of the albumin-related indices including prognostic nutritional index (PNI), C-reactive protein-to-albumin ratio (CAR) and C-reactive protein-albumin-lymphocyte ratio (CALLY) for dCCA patients (12–15).