الفهرس 
TitleOnly 14 pages are availabe for public view
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Abstract
BC is the most frequently diagnosed cancer and a second leading cause of cancer death in women worldwide, with more than one million new cases and 370,000 deaths yearly worldwide. It is a heterogeneous disease encompassing various subtypes showing differences in incidence, therapy response and prognosis. Precise oncology is dependent on characterization of prognostic subgroups. Thus, exploration of noval biomarkers and improved characterization of established factors are important to tailor therapy. Cancer stem cells are defined as cells within tumor that possess the ability to self-renew and to cause the heterogeneous lineages of cancer cells that comprise the tumor. They have been identified in BC. It is often considered to be associated with chemo-resistance and radio-resistance that lead to the failure of traditional therapies.
In the present study, we attempted to assess serum levels of soluble cluster of differentiation 44 (sCD44) and transforming Growth factor-beta (TGF-β) in female patients with breast cancer
Forty female patients who were newly diagnosed with BC were enrolled into the study as patient groups. Forty women with normal mammography findings and no previous history of any kind of cancer with matched age and menopausal status served as control group.
A venous blood sample were collected concurrently from each breast cancer patient (Before surgery) and from each control subjects. All blood samples we obtained at fasting early in the morning and the serum was immediately separated by centrifugation and stored at -70° until use. Serum sCD44 and TGF-β levels were measured by enzyme linked Immunosorbent assay.
In this study, the serum concentrations of sCD44 were examined in 40 BC patients and 40 normal control subjects. The result offered evidence that there is significant difference in Serum concentration of sCD44 between BC patients and normal control subjects group where the serum concentrations of sCD44 were higher in the BC patients in comparison to normal controls.
Regarding the correlation between sCD44std and clinico-pathological characteristic of the tumor, it was observed that there was a significant positive correlation between sCD44 and tumor stage and Her-2 neu expression. This Suggests the association between sCD44 and tumor aggressiveness and invasion and indicates the importance of the molecule in progression of BC.
The current study showed that serum levels of TGF-β in BC patients was significantly higher than their corresponding control value. This suggests that TGF-β may havea role in BC progression. Regarding the correlation of TGF-β and clinic-pathological characteristic of the tumor, our study showed that TGF-β was positively significantly correlated with tumor stage which may reflect the association of TGF-β with severity and invasiveness of BC.
Summary and Conclusions
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The diagnostic performance of serum sCD44 and TGF-β was evaluated by The receiver operating characteristic curve which demonstrated that, sCD44 and TGF-β had a good diagnostic value
In the current study the Follow-up was made to answer the question of whether the preoperative serum sCD44 levels was of prognostic significance. Notably after 26 months, our results showed that BC patients with preoperative high levels of serum sCD44 had shorter mean disease free survival time and poor prognosis than patients with lower serum levels.
The prognostic value of serum TGF-β was evaluated by Kaplan-Meier disease free survival curve which demonstrated that BC patients with elevated levels of serum TGF-β above the cutoff value had shorter mean DFS time than BC patients with lower TGF-β. So serum TGF-β may help to identify a high risk population and has potential to promote metastasis and recurrence for BC patients.
In the current study, there was a significant positive correlation between serum TGF-β and serum sCD44.