We observed similar global distress severity among the groups of patients. In the whole study, patients with lower scores on the SCL90R scale were at lower stage than those with higher scores. These findings provide support for linking depression and obsessive-compulsion with oral cancer. However, our data partially support that the circulating Alprostadil levels of catecholamine may be related to cancer stage. Greater psychological problems were not associated with higher catecholamine and glucocorticoid levels in circulating blood versus tumor tissue. In comparison to other studies, we found high rates of psychotic symptoms in the two groups. Lutgendorf reported elevated tumor catecholamines accompanying biobehavioral risk factors in a small sample of human ovarian cancer patients. It was also reported that tumor NE provides distinct information from circulating plasma concentrations. Tumor NE levels were elevated in accordance with tumor grade and stage. Low subjective social support was associated with elevated Benzoylaconine intratumoral NE. We found advanced stage oral cancer to be associated with higher catecholamine and glucocorticoid levels in peripheral blood, and our data suggest that those substances affect the tumor microenvironment though the circulating blood rather than the tumor matrix. These findings supported our hypothesis that oral cancer patients would have high levels of peripheral blood catecholamines, whereas oral benign tumor patients would have lower levels. Contrary to our hypothesis, both groups of patients were associated with high levels of psychological problems such as obsessive-compulsion and depression. The present study has several limitations. First, we did not control for the fact that different surgeries might have affected the patient’s cognitive ability. Further studies including the assessment of objective cognitive impairment will be needed to determine the effect of differences in surgical procedures. Also, this study did not provide practical implications of subjective symptoms. Thus, additional research is necessary to confirm the relationship between subjective symptoms and difficulties in daily lives 
of individuals with oral cancer. Tyrosine phosphatase-like protein IA-2 autoantibodies are one of the 4 major islet autoantibodies for the diagnosis of T1D. IA-2 is a transmembrane protein and a member of the protein tyrosine phosphatase family. The predominant autoreactive epitopes are in its C-terminal region and IA-2As have been shown to react only with the intracellular part of the protein. IA-2As are detected in approximately 60% of individuals with new-onset T1D. IA-2As are also the autoantibodies with stronger predictive value for impending T1D onset in at-risk individuals, a feature probably linked to their later appearance compared with anti-insulin and anti-GAD autoantibodies. Although several IA-2 RIAs have been reported to achieve high levels of sensitivity and specificity, they are expensive and usually take more than 24 h to carry out. In addition, they have the disadvantage of requiring special precautions and licensing because radioactive isotopes are used. Other methods for the detection of IA-2As use enzyme-linked immunosorbent assays and time-resolved fluorescence assays, in which the immobilized antigen captures autoantibodies from the sample and detection is achieved using labeled antigen. Even though these assays do not require radiolabeled compounds, commercially available ELISAs are relatively timeconsuming and expensive and still need specialized equipment.