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Gene & Protein in Disease Testosterone as a biomarker of colorectal cancer

1. Introduction CRC have yielded conflicting results [13,19] . To the best of our
knowledge, no epidemiologic research has examined the
Cancer is a devastating disease that has been the subject relationship between testosterone levels and the risk of
of continuous study for over a century. According to the CRC in the South Indian population. This study aimed
International Agency for Research on Cancer, cancer was to evaluate the relationships between testosterone levels
responsible for nearly 1.9 million incidence cases and 0.9 and the likelihood of CRC among patients in this region.
million deaths in 2020. One specific example of cancer is Investigating the relationship between testosterone levels
colorectal cancer (CRC), which affects the colon and the and CRC in the South Indian population holds significant
rectum [1,2] . Examining the connection between testosterone promise for advancing medical knowledge and patient
and CRC within the South Indian population is imperative, care. It has the potential to provide population-specific
given the unique characteristics of this demographic insights, contribute to personalized medicine, improve risk
and the potential implications for cancer prevention and assessment, guide treatment strategies, inform preventive
treatment. Such research can substantially enhance our measures, advance scientific understanding, and have
understanding of CRC and enable the customization of broader implications for global health. This research has
healthcare strategies to address the specific needs of this the potential to improve the quality of life for individuals
region. in South India and contribute to the global effort to

Various factors have been identified as influential in combat CRC.
determining cancer susceptibility . As an illustration,
[3]
testosterone levels are widely recognized for their 2. Materials and methods
significance, particularly in the development of the 2.1. Subject recruitment
male reproductive system . Testosterone is primarily In the present study, blood samples of CRC patients were
[4]
synthesized in the smooth endoplasmic reticulum of Leydig collected from hospitals in Tamil Nadu, South India. CRC
cells, which are located in the testes and produced through was diagnosed based on distinct peripheral blood cytology,
the traditional pathway from cholesterol . In the testicular standard clinic-hematological criteria, and baseline
[5]
interstitial tissue, Leydig cells serve the primary function clinical findings that were recorded and confirmed by
of producing testosterone to support spermatogenesis and an oncologist. Patients diagnosed at various stages of the
various extratesticular androgenic, and anabolic functions. illness were enrolled in the study, and diagnostic criteria
The transport of testosterone to its target sites relies on were applied. Each participant underwent a personal
the serum glycoprotein called sex hormone-binding interview and completed an open-ended questionnaire
[6]
globulin (SHBG) , which is synthesized in the liver. SHBG to obtain pertinent clinical information, including factors
forms strong bonds with three sex hormones: estrogen, such as age, smoking behaviors, and alcohol history. The
dihydrotestosterone, and testosterone, facilitating these study was conducted based on the medical data provided
three hormones throughout the body. Reference ranges by the practitioners. The samples, collected by the doctors
for testosterone levels can vary significantly,with reported for the investigation, were further used in subsequent

limits for men ranging from as low as 10 to as high as experiments.
35 nmol/L, and for women, from as low as 0.5 to as high as
2.4 nmol/L [7-10] . 2.2. Sample collection
Recently, emerging evidence has established a statistically Approximately 7 mL of blood samples were collected from
significant positive relationship between circulating patients diagnosed with CRC through venipuncture at
endogenous sex hormone levels and the risk of developing hospitals. Blood samples were also voluntarily collected
CRC [6,11,12] . In men, higher levels of total testosterone have from healthy individuals using the same method to serve as
been associated with a decreased risk of CRC, and there controls for comparative analysis. The overarching goal of
appears to be an inverse relationship between the estradiol- employing the same blood collection method is to ensure
to-testosterone ratio and CRC . Both genetic and that control subjects closely resemble patients in all relevant
[13]
environmental factors, which can influence sex hormone aspects except for the specific exposure or condition under
levels, have been linked to an increased risk of CRC [14-17] . investigation. This approach allows researchers to make
Within the Women’s Health Initiative Clinical Trial valid comparisons and derive meaningful conclusions from
(WHI-CT), a nested research study revealed that exposure their study findings. Venipuncture is a common medical
to the highest and lowest SHBG concentration groups procedure that demands careful attention to detail and
was associated with a more than twofold increased risk of strict adherence to safety protocols to ensure the proper
CRC [6,18] . However, several smaller studies examining the collection and handling of blood samples while minimizing
relationship between circulating SHBG concentrations and discomfort or complications for the patient. The blood was

Volume 2 Issue 3 (2023) 2 https://doi.org/10.36922/gpd.1082