الفهرس 
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Abstract
Breast cancer has been reported as the most common causes of death in female. Worldwide, over 1.1 million women are diagnosed with breast cancer each year. The incidence and fatality rate is increasing globally, including third world that had low rate history. Incidence and fatality increase with age, 50% percent of women with age of 65 and above die of the disease. Breast cancer causes significant morbidity and disability in surviving woman. For optimum management of breast cancer patients, assay of certain biochemical markers is necessary such as estrogen and progesterone receptors and CA 15-3.
Over the last several years, researches on the role of apoptosis in malignancy in general and in breast cancer in particular had increased. Apoptotic markers such as migration-inhibitory factor (MIF), soluble factor of apoptotic signal (sFas), soluble intercellular adhesion molecule (sICAM) and plasminogen activator inhibitor 1 (PAI-1) are now being investigated to have a role in detecting the progression of cancer and its response to various chemotherapeutic agents.
This study was carried out to clarify the clinical significance of sFas in breast cancer female patients. Serum sFas concentration was measured in healthy, primary and recurrent breast cancer patients, and then compared with serum cancer antigen 15-3 (CA15-3) as the most commonly used breast cancer tumor marker
In this study, serum samples were taken from 24 primary breast cancer patients, 24 recurrent breast cancer patients and 24 normal healthy controls with matched age group. The level of sFas in the sera was determined by ELISA method using human sFas ELISA kit. While the serum level of CA 15-3 was determined by Enzyme Linked Fluorescent assay (ELFA) method using VIDAS CA 15-3.
The results of our study demonstrated that the interquartile range of the serum levels of sFas were significantly elevated in recurrent breast cancer (RBC) patients (3669-5030 pg/ml) and primary breast cancer (1ryBC) patients (2545-3543 pg/ml) than healthy control subjects (787.5-1276.5 pg/ml). Also, the interquartile range of the serum levels of Ca15-3 were significantly elevated in RBC patients (39.5-244.5 u/ml) and 1ryBC patients (33.5-40.5 u/ml) than healthy controls (12.5-20 u/ml). In RBC patients, serum sFas showed greater significant AUC (0.852 with p value= 0.668) than that of serum Ca 15-3 (0.817 with p value= 0.668).The sensitivity, specificity and cut-off value for sFas were79%, 79% and 3651 pg/ml respectively. While 62.5%, 75.% and 41 U/ml for serum Ca 15-3 respectively. In 1ryBC patients, serum sFas showed equal significant AUC (1 with p value = 1) as serum Ca 15-3 with equal sensitivity (100%) and specificity (100%) at a cut-off value of(2050pg/ml), and cut-off value for serum Ca 15-3 was 32 U/ml.