Clinical Rationale of Dual-Parameter Tumor Markers Reporting Without Reliance on Normal Reference Ranges

Area of Science:

• Oncology
• Biochemistry
• Medical Diagnostics

Background:

• Current tumor marker (TM) interpretation relies solely on absolute values, limiting their effectiveness in cancer screening and recurrence detection.
• TMs alone do not provide the detailed information comparable to histological data.
• Asymptomatic patients with rising TMs are typically only investigated with imaging if levels exceed established norms.

Purpose of the Study:

• To propose a novel, two-parameter system for reporting tumor markers (TMs).
• To advocate for the integration of specific growth rate (SGR) alongside TM levels for enhanced clinical utility.
• To highlight the potential of SGR in improving cancer recurrence monitoring and prognosis assessment.

Main Methods:

• Reviewing existing literature on TM velocity, doubling time, and SGR in radiological assessments.
• Proposing the universal adoption of a two-parameter TM reporting format: TM level and its SGR.
• Defining SGR as a calculation incorporating current TM value, previous TM value, and the time interval between them.

Main Results:

• The specific growth rate (SGR) of tumor markers (TMs) offers a more reliable criterion for recurrence monitoring than TM levels alone.
• Radiological tumor progression assessments are significantly aided by SGR calculations, improving prognosis.
• The proposed SGR-TM format is easy to interpret (percentage change per day), cost-effective, and mathematically consistent.

Conclusions:

• Implementing SGR in laboratory practice for tumor marker reporting requires further testing but holds significant promise.
• The two-parameter TM reporting (level and SGR) can provide a more nuanced and reliable approach to cancer management.
• This enhanced TM reporting method can aid in guiding therapy and monitoring for recurrence more effectively.