الفهرس 
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Abstract
In the present study, we evaluated the diagnostic and prognostic values of serum tissue polypeptide specific antigen (TPS) and superoxide dismutase (SOD) in breast cancer patients. Determination of serum CAl 5.3 levels was also added to this study as a standard diagnostic and prognostic marker in breast cancer. This study included 45 females divided into three groups:
Group I; 15 premenopausal females with primary breast cancer.
Group II: 15 females with benign breast lesions, of matched age and . menstrual state as group 1 patients.
Group III: 15 normal healthy volunteers as control.
All patients were subjected to surgery (Modified Radical Mastectomy) and then they received adjuvant combination chemotherapy [ Cyclophosphamide, Methotrexate and 5-Fluorouracil (CMF)] or [5-Fluorouracil, Adriamycin and Cyclophosphamide (FAC)] for 6
cycles.
Three blood samples were taken from each patient of group I, before surgery, two weeks after surgery and after 6 cycles of chemotherapy . Also, one blood sample was taken from each subject of the benign and control groups.
Serum TPS and SOD levels were measured using ready-to-use ELISA kits.
Serum CAl5.3 was determined using ready-to use EIA kits. The response of the breast cancer patients to the chemotherapeutic drugs was evaluated based upon the changes occurred in the serum levels of these parameters.
The serum level of TPS was statistically significantly higher in the breast cancer patients group than the control group. This means that serum TPS can be used to diagnose breast cancer patients. Also, this indicates that serum TPS may have a role in breast cancer progression. In addition, the serum level of TPS was statistically significantly higher in the breast cancer patients group than the benign breast lesions group.
Moreover, treating the patients with 6 cycles of chemotherapy significantly decreased the serum level of TPS compared with its serum levels after 2 weeks of surgery. This means that serum TPS level can be used to monitor the breast cancer patient’s response to chemotherapy.
The results indicated that serum TPS was significantly correlated with both lymph node involvement and clinical stage. These results indicated the usefulness of using serum TPS as a prognostic marker to predict the breast cancer patient’s clinical outcome.
Regarding the diagnostic value of the serum level of SOD, it was statistically significantly higher in breast cancer patients group than the control or benign groups that may justify its use as a diagnostic marker for breast cancer.
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With respect to the role of serum SOD. our results showed that treating the patients with 6 cycles of chemotherapy significantly decreased the serum level of SOD compared with its serum levels after 2 weeks of surgery.
The results indicated that serum SOD was significantly correlated with each of tumour size, lymph node involvement and clinical stage. These results indicated the usefulness of using serum SOD as a prognostic marker to predict the breast cancer patient’s clinical outcome.
According to the results of the present study, the serum levels CAI5.3 were statistically significantly higher in the breast cancer patients than the control group. This indicated that it can be used to diagnose breast cancer patients and discriminate them from control subjects.
Regarding the prognostic value of serum CA15.3, our results showed that the serum levels of CA15.3 were significantly correlated with tumour size, lymph node involvement and clinical stage. This indicated that CAI5.3 might have a prognostic role in patients with primary breast cancer.
Our results showed significant correlations between serum levels of CA15.3 and each of TPS and SOD before surgery. Also, there was a significant correlation between serum levels of SOD and TPS before surgery. After two weeks of surgery, there was a significant indirect correlation between serum levels of CA15.3 and TPS.
In the present study, it was found that TPS. CA15.3 and SOD were diagnostic markers for breast cancer. On comparing their diagnostic values to determine which one is superior to the others, the ROC curve analysis was applied for such purpose. Inspection of the three curves showed that the ROC curve for serum SOD was above the ROC curves for serum CA15.3 and TPS. Also, the area under the curve was 100% for serum SOD, 89.5% for serum CA15.3 and 79.0% for TPS. The optimum cut-off value selected for serum SOD was 102.25 ng/ml, at which the sensitivity was 100% and the specificity was 100%. While for CA15.3 the optimum cut off value was 19 lU/ml, at which the sensitivity was 100% and the specificity was 100%. For TPS the optimum cut off value was 42.5 U/ml, at which the sensitivity was 80% and the specificity was 80%. So, serum SOD was superior to serum levels CA15.3 and TPS as a diagnostic marker in premenopausal breast cancer females.