Correlation between tumor markers in pre and post treatment of pancreatic cancer patients

One of the main causes of death in India is pancreas cancer. Various blood tumour indicators such as 19-9 carbohydrate antigen (CA19-9), antigen125 carbohydrate (CA125), antigen carcinoembryogenic (CEA) and alphaetoprotein (AFP) imbalance are observed in therapy for cancer. In disease predictions, thorough monitoring of the change in serum tumour markers was highly essential. The present investigation was thus conducted to examine serum marker tumour profiles before and after therapy of individuals with pancreatic cancer. The study comprised 400 individuals from both sexes suffering from pancreatic carcinogenic malignancy. In the pre and post-treatment of patients we detected serum tumour markers. In post-treatment groups, serum tumour marker levels were lower than before the individuals were treated. However, using pairs of samples t-testing at pfleg.0.05 these changes were statistically significant. Marker alterations in the serum tumour have shown risk for individuals. These alterations therefore enable the cancer individuals to predict and monitor properly.

Challenging presentations of germ cell tumours in routine clinical practice

Testicular cancer is the most common malignancy in young men. We discuss four cases of germ cell tumours (GCTs) presenting to general practitioners and physicians where there were notable preventable delays in the diagnosis and management. This diagnostic delay is associated with a more advanced stage of disease, and subsequent increased treatment-related morbidity and decreased survival. Our series highlights the variety of ways in which GCTs may present and we discuss the importance of prompt diagnosis through a thorough history and examination, early measurement of serum tumour markers and appropriate multidisciplinary team discussion. GCTs are highly curable cancers in the majority of patients and delays in management can, therefore, have devastating consequences.

Improving outcomes in germ cell cancers using miRNA

Owing to advances in treatment paradigms across the last five decades, testicular cancer is now eminently curable. However, current serum tumour and imaging biomarkers lack adequate sensitivity, specificity, and predictive value. Subsequently, their utility in detecting active malignancy and informing treatment decisions is minimal in a large proportion of men with testicular cancer. Micro-ribonucleic acids (miRNA), pertinently miR-371a-3p, offer a new tool, which based on early data, appears to fill many of the gaps that existing biomarkers leave. This paper reviews the evolution of the technology, potential limitations, and discusses the clinical relevance of miRNA as it moves towards the clinic.

Serum tumour markers combined with clinicopathological characteristics for predicting MMR and KRAS status in 2279 Chinese colorectal cancer patients: a retrospective analysis

Background Although serum tumour markers (STMs), clinicopathological characteristics and the status of KRAS and MMR play an important role in optimizing the treatment and improving the prognosis of colorectal cancer, their interrelationships remain largely unknown. Methods A retrospective analysis of 2279 patients who underwent KRAS or MMR status testing and STM measurements prior to treatment over the past four years was conducted. Univariate and multivariate logistic regression were performed to identify independent predictive factors of KRAS and MMR status. The area under receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive value of individual and combined factors. Results Of the 784 patients tested for KRAS and 2279 patients tested for MMR status, KRAS mutations and dMMR were identified in 276 patients (35.20%) and 177 patients (7.77%), respectively. Logistic regression analysis demonstrated that right colon, well and moderate differentiation and negative CA19-9 were independent predictors for KRAS mutations. The ROC curve yielded an AUC of 0.609 for the combination of the three factors. Age < 65 was an independent predictive factor for dMMR, along with tumour size > 4.6 cm, right colon, poor differentiation, harvested lymph nodes ≥ 22, no lymph node metastasis, no perineural invasion, negative CEA and positive CA72-4. When the nine criteria were used together, the AUC was 0.849. Conclusion Both STMs and clinicopathological characteristics were found to be significantly associated with the status of KRAS and MMR. The combination of these two factors possessed a strong predictive power for targeted genes among CRC patients.

The value of haematological parameters and serum tumour markers for predicting KRAS mutations in 784 Chinese colorectal cancer patients: a retrospective analysis

Background Identifying the mutation status of KRAS is important for optimizing treatment in patients with colorectal cancer (CRC). The aim of this study was to investigate the predictive value of haematological parameters and serum tumour markers (STMs) for KRAS gene mutations. Methods The clinical data of patients with colorectal cancer from January 2014 to December 2018 were retrospectively collected, and the associations between KRAS mutations and other indicators were analysed. Receiver operating characteristic (ROC) curve analysis was performed to quantify the predictive value of these factors. Univariate and multivariate logistic regression models were applied to identify predictors of KRAS mutations by calculating the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results KRAS mutations were identified in 276 patients (35.2%). ROC analysis revealed that age, CA12–5, AFP, SCC, CA72–4, CA15–3, FERR, CYFRA21-1, MCHC, and tumor location could not predict KRAS mutations (P = 0.154, 0.177, 0.277, 0.350, 0.864, 0.941, 0.066, 0.279, 0.293, and 0.053 respectively), although CEA, CA19–9, NSE and haematological parameter values showed significant predictive value (P = 0.001, < 0.001, 0.043 and P = 0.003, < 0.001, 0.001, 0.031, 0.030, 0.016, 0.015, 0.019, and 0.006, respectively) but without large areas under the curve. Multivariate logistic regression analysis showed that CA19–9 was significantly associated with KRAS mutations and was the only independent predictor of KRAS positivity (P = 0.016). Conclusions Haematological parameters and STMs were related to KRAS mutation status, and CA19–9 was an independent predictive factor for KRAS gene mutations. The combination of these clinical factors can improve the ability to identify KRAS mutations in CRC patients.