Importantly, we successfully developed sensitive AAL-based reverse lectin ELISA in this study for measurement of fuco-SERPINA1 levels in plasma specimens, and reported for the first time that both plasma fuco-SERPINA1 and SERPINA1 protein levels are significantly elevated in patients with distant metastatic PC (Figure 6) in association with poor prognosis in OS (Figure 8). This evidence concerns the gene SERPINA1 and pachyonychia congenita.