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Poster session 01

92P - Analysis of standard serum biomarker levels in patients with non-specific symptoms seen at Guy´s rapid diagnostic clinic

Date

10 Sep 2022

Session

Poster session 01

Topics

Laboratory Diagnostics;  Translational Research;  Cancer Epidemiology

Tumour Site

Presenters

Maria Monroy Iglesias

Citation

Annals of Oncology (2022) 33 (suppl_7): S27-S54. 10.1016/annonc/annonc1037

Authors

M.J. Monroy Iglesias

Author affiliations

  • Translational Oncology And Urology Research, KCL - King's College London, WC2R 2LS - London/GB
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Abstract 92P

Background

Rapid diagnostic clinics (RDCs) were set up by NHS England to provide an alternative pathway for patients with non-specific symptoms (e.g. weight loss and fatigue) concerning of malignancy, who are not suitable for a site-specific route. The aim of the current study was to perform a preliminary analysis of the serum biomarker levels of patients attending an RDC and subsequently diagnosed with cancer, as compared to those patients diagnosed with a mild benign disease or with no clear organic cause for their symptoms.

Methods

We analyzed the current panel of standard serum biomarkers taken at referral for patients seen at Guy´s RDC between December 2016 and April 2022. We compared the distribution of biomarkers based on the clinical cut-off levels between those diagnosed with cancer (n=283) and those with a mild benign diagnosis or with unknown cause for their symptoms (n=1,787).

Results

The biggest differences were observed for inflammatory markers (i.e., erythrocyte sedimentation rate (ESR), ferritin, lactate dehydrogenase (LDH), C reactive protein (CRP)), albumin, alkaline phosphatase (ALP), and serum free light chain (SFLC) ratio. Compared with the non-cancer population, more cancer patients had high levels of ESR (³14mm/hr) (36% (n=103) vs 17% (n=301)), ferritin (³276ug/L) (21% (n=59) vs 6% (n=108)), LDH (³225 U/L) (34% (n=95) vs 17% (n=302)), CRP (³4 mg/L) (56% (n=157) vs 20% (n=356)), ALP (³130mL/min) (27% (n=77) vs 5% (n=86)), platelets (³400x109) (11% (n=31) vs 3% (n=45)), and SFLC ratio (³1.65) (12% (n=33) vs 4% (n=68)). Conversely, 25% (n=70) of cancer patients had low albumin levels (<40 g/L) compared with 4% (n=68) of the non-cancer population.

Conclusions

Preliminary descriptive analysis of data showed that cancer patients with non-specific symptoms commonly present with abnormal inflammatory markers, albumin, ALP, platelets, and SFLC ratio, compared with patients diagnosed with a mild benign disease or with no clear organic cause for their symptoms. This is the first step in the development of a risk-stratification tool which will aid in the early diagnosis of cancer in patients who present with non-specific symptoms in the RDC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.

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