الفهرس 
TitleOnly 14 pages are availabe for public view
 |  | from | 103 |  |  |
| | | from | 103 | | |
Abstract
In the present study, we evaluated the diagnostic, prognostic and follow up values of serum p27 level & tissue p27 expression in comparison with serum CA15-3 in breast cancer females having recently detected breast carcinoma of clinical stages ΙΙ and ΙΙΙ, before surgery, 2 weeks following surgical removal of the breast and after 6 cycles of FAC chemotherapy. Serum p27 and CA15-3 levels were measured in serum samples collected from normal healthy control group (n=22) and breast cancer patients group (n=22). Tissue samples collected from breast tumor tissues (n=22) and the adjacent normal healthy tissue to breast tumor (n=22). Serum p27 level was measured in all studied groups by ready-to-use Enzyme linked immunosorbentassay (ELISA) kit. Serum CA15-3 was measured using a ready-for- use Immunoradiometric assay (IRMA) kit.Tissue expression of p27 was measured using a ready-for-use immunohistochemistry detection kit.
The serum level of p27 was significantly lower in breast cancer patients group compared with the normal healthy controls group. There was a significant increase of the serum level of p27 after 2 weeks of surgery compared with its level before surgery in the breast cancer group. In addition, there was a significant elevation of the serum level of p27 in response to 6 cycles of chemotherapy compared with its level after 2 weeks of surgery in breast cancer group. These results indicated that, serum p27 level may be considered as a diagnostic biomarker in breast cancer and can be used as a useful marker to monitor the effect of surgery and chemotherapeutic treatment in breast cancer patients.
Tissue expression of p27 was significantly declined in breast tumor tissues compared with normal breast tissues with 50% sensitivity and 100% specificity. Our results showed no significant correlation of tissue expression of p27 with clinicopathological data in breast cancer patients group.
According to the results of the present study, the serum levels of CA15-3 were significantly higher in breast cancer patients than the controls. There was a significant decrease of the serum CA15-3 after 2 weeks of surgery compared with its level beforesurgery in the breast cancer group. In addition, there was a significant decrease of the serum level of CA15-3 in response to 6 cycles of chemotherapy compared with its level after 2 weeks of surgery in breast cancer group. Our results showed a significant correlation of serum CA15-3 with lymph node involvement in breast cancer patients group.
In present study, it was found that serum p27 and serum CA15-3 were diagnostic markers. On comparing their diagnostic values to determine which one is superior to the other, the ROC curve analysis was applied. Inspection of the two curves showed that the ROC curve for serum p27 was above ROC curve for CA15-3. The area under the curve was 88.4% for p27 and 82.9% for CA15-3. The optimum cut-off value selected for serum p27 was 10.55ng/ml at which the sensitivity was 81.8% and the specificity was 99.9% and the optimum cut-off value selected for serum CA15-3 was 24IU/ml at which the sensitivity was 63.6% and the specificity was 99.1%. Hence serum p27 is superior to CA15-3 as a diagnostic tumor marker in breast cancer patients.
The results of current study showed that tissue expression p27 can predict breast cancer with sensitivity of 50% and can indicate normal tissue by specificity 100% while for serum p27 levels the sensitivity 81.8% and specificity was 99.9%. This means that both of serum and tissue expression p27 has the same specificity with the advantage of serum p27 which has sensitivity 81.8%. This means that serum level of p27 can predict higher percent of breast cancer patients compared with tissue p27 expression. Besides that no one can deny the convenience given to the patients while taking blood sample compared with taking tissue sample.
Up to the best of our knowledge, this is the first study comparing the diagnostic values of these three parameters using the ROC curve analysis showing serum p27 as the most superior diagnostic marker. Serum p27 was also found to have a role in monitoring the effect surgery & chemotherapy on breast cancer patients. Also, serum p27 was found to have a correlation with disease-free survival of breast cancer patients which means that the level of serum p27 can be used to predict the clinical outcome of breast cancer patients.