Mean ALP, TSH and ESR differed across patient groups, considering patients with CIS and patients with RRMS clusters 1–3 (F = 3.372, p = 0.028; F = 3.783, p = 0.018 and F = 2.765, p = 0.054, respectively; Table 3). This evidence concerns the gene ESR1 and in situ carcinoma.