What's E-selectins, in particular? My mother has a KRAS mutation (G13D)
-selectin stands for E
pithelial cell, sialyl Lewis adhesion molecules that increase the efficiency of metastatic spread by cancer cells. The best indicators of this Velcro-like mechanism's involvement are a patient's tumor tissues pathologically stained with CA199 and
CSLEX1 antibodies. The CSLEX1 antibody is a specific CD15s variant. The CSLEX1 marker is not easily available, clinically, outside of Japan. CA199 alone does ~4/5 to ~5/6s of the marker pair's work. Basically e-selectin is involved in about 2/3 of advanced CRC patients (3s and 4s) at diagnosis or surgery, and is very predictive of recurrence risk for stage 2 patients where detected. Blood measurements are affected by other body sources of CA199; ideally healthy patients range 0 - 19 with a genetic few up to 22. Other "benign" disease processes can raise CA199 higher and overlap or amplify cancer cases' CA199. Other blood panels (e.g. inflammation, thyroid, sugar)can help control, rule out, or adjust for this - definitely more work and more slop factor. But if tumor CA199 is present, a few good uses along the way can make or break treatment success.
If you report any CA199 preop/post op data, it may help future readers as well as yourselves. CA199 during Folfox is usually overwhelmed by interferences after a few treatments. For us, with metronomic 5FU, milder drugs, anti-inflammatory supplements, steady blood sugar etc, and no recurrence, CA199 was very steady.
her CEA and CA199 levels are within normal range per the ones established by this particular lab.
It's best to not rely on "normal ranges" for CEA and CA199 for series of levels. They are statistically developed around single readings at some point in time (diagnosis, pre-op, post-op, chemo follow up) rather than a series of readings, which can be far more sensitive, especially in patients with low markers, near or below the cutoff at diagnosis.
CA199 interpretation is clinically developed around pancreatic cancer, with lab cutoff scores 34 - 40 units most commonly at 37. Often PanCan patients have CA199 readings in the hundreds or thousands. The upper 50-90% of initially diagnosed CRC patients are mostly in the 19 - 60 units range; about 3/4 of advanced CRC patients could theoretically produce some rising CA199 series of measurements from their tumors' growth. As a practical matter, any CRC patient with a pre-op CA199 about the teens should consider CA199 tissue stains. Especially for CA199 above 19 or 22 I'd be cracking the whip to get a pathologist to stain the tumor tissue for both CA199 and CSLEX1, in light of previous cimetidine research.
How did you go about optimizing which components to use??
By (m)any means
Do you target particular biomarkers or experiment and observe?