Association of Positive Results of Single Serum Biomarker with the Clinical Parameters

Background: Many serum biomarkers have been developed to diagnose cancers at an early stage and monitor drug therapy. At present, the most common clinical used serumtumor biomarkers are mainly including Alpha-Fetoprotein (AFP), Carcinoembryonic Antigen (CEA), Neurone Specific Enolase (NSE), Total Prostate Specific Antigen (TPSA), Human Epididymis Secretory Protein 4 (HE4), Carbohydrate Antigen 125 (CA125), CA153, CA19-9, CA72-4 and Serum Ferritin (SF). However, more and more studies have shown that serum markers were poor specific and sensitive in cancer early diagnosis, even among the most correlative cancers.


Introduction
With dramatical population growth and aging worldwide, cancer incidence and mortality become the major public health concern affecting more than millions of people each year [1]. With nearly one-quarter of the people in the world, cancer deaths of China as well as have a severe impact on global cancer trend and burden [2]. As we know, early diagnosis usually could increase the chances of successful treatment which gives great promises for cancer patients [3]. And major advances have been made in screening tissue or blood samples for cancer-specific biomarkers that can detect the cancer as early as possible [4,5]. So far, series of serum biomarkers have been adapted to clinical use for cancer diagnosis, therapy and prognosis monitoring [6]. For example, AFP, a marker for hepatocellular carcinoma, sometimes is used to assess hepatic masses in patients at particular risk for developing hepatic malignancy [7].
CEA is expressed in normal mucosal cells and overexpressed in adenocarcinoma, especially colorectal cancer [8,9]. NSE has been evaluated in numbers of malignant tumours, such as lung cancer [10,11]. HE4 [12][13][14] and CA125 [15,16] have an obvious elevated expression levels in ovarian cancers. CA15-3 is a protein made by a variety of cells, particularly breast cancer cells [17,18]. Elevated levels of CA19-9 occur primarily in patients with pancreatic cancers but also have been reported in patients with other malignancies [19][20][21][22]. It was reported CA72-4 was the most correlative serum biomarker for the detection of gastric cancer in Chinese population [23,24]. Serum Ferritin (SF) can be used as a prognostic biomarker 2/6 Volume 18-Issue 3 DOI: 10.26717/BJSTR.2019. 18.003153 for survival in relapsed or refractory metastatic colorectal cancer [25]. With adenocarcinoma in older men, significant PSA elevations have enough specificity to make the diagnosis of prostate cancer, and so on [26,27].
Due to the convenience and non-invasion, those serum biomarkers have been widely used in clinical practice. However, to date, many serum biomarkers have been demonstrated poor specificity and efficacy, even among the most correlative cancers.
Because of the overabundance of diagnostic value and clinical significance, it is necessary for doctors and patients to have a thorough understanding of those serum biomarkers [28,29].
The study aimed to provide a comprehensive overview of the relationship of the positive results of serum biomarkers and its distribution with the patient's gender, age and types of disease, and offer more references for clinical practise.  Table 1. All statistical analyses were performed on the positive cases of each tumor marker.  Table 2.

Results
In this study, the positive results of ten kinds of serum-based biomarkers were statistically analysed according to the types of diseases, gender and age as shown as in Figure 1. Firstly, the rates of positive results associated with the diagnosis, treatment or prognosis for the cancer were calculated. The rates above 50% were respectively from CEA (62.13%) and CA125 (50.10%). For NSE and  In our study, we also found that when patients were suffering rectal cancer or gastric cancer, the serum level of AFP marker were high. As shown, anemia was a common blood disorder for both male and female patients when SF serum level was high above the cut-

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From the results, the cases of three categories for each biomarker were mainly distributed in twice the reference interval and the results from the patents associated with tumor were distributed in each reference interval. And the certain tested results of the biomarkers were not directly related to the type of disease.

Discussion
In this study, most single serum biomarkers had relatively low diagnostic value for cancer, even for the most correlative cancer. because of its convenience and non-invasion. In the future, the trend will be to explore more specific and sensitive genomic, proteomic, and epigenetic biomarkers and simultaneously measure those biomarkers by more specific and sensitive techniques [30][31][32].

Conflicts of Interest
There are no conflicts of interest regarding the publication of this paper.

Funding Statement
This study was supported by Sichuan Provincial Health and Family Planning Commission Research Project (No.18PJ011).