الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
BC is the most frequent cancer among women. It is also the world’s second biggest cause of cancer mortality. According to malignancy statistics 2020, BC accounts for 30% of all female malignancies, with 276,480 new BC and over 42,000 mortality expected in 2020. 33% of all female cancer cases in Egypt are caused by it, and more than 22,000 new cases are discovered yearly. The most frequent location for advanced BC metastatic spread is bone tissue. The interaction between some cells in the bone microenvironment and metastatic BC cells leads to metastatic bone disease, which signals a poor prognosis and negatively impacts the quality of life for these individuals. Treatment of breast cancer metastatic to bone involves inhibition of tumor cell proliferation or killing of cancer cells to extend the patient’s survival time. This could be achieved by usage of cytotoxic drugs, hormonal deprivation, or inhibition of specific signaling pathways by targeted agent. The objective of this study was studying the role of CD47, FOXF2, lysyl oxidase (LOX) and Ca15.3, and response to radiotherapy in bone metastasis breast cancer. This is study included group I: 40 apparently normal healthy controls group II: Included 40 breast cancer patients with BMBC patients were treated with fractionated radiotherapy. group III: Included 40 non metastatic BC patients. CD47, FOXF2 and LOX genes expression in BMBC and primary BC patients were assayed by RT-PCR.Ca 15.3 serum levels in BMBC pateints level were assayed by ELISA.
Our result showed that:
In BMBC pateints CD47 and LOX genes expression and Ca15.3 serum level either before or after radiotherapy are statistically significantly higher than that in control group. All these biomarkers significantly deceased after RT treatment.
In BMBC pateints, FOXF2 gene expression either before or after radiotherapy is statistically significantly lower than that in control group.
In non metastatic BC tissues, CD47and LOX genes expression are statistically significantly higher than that in normal adjacent breast tissues, while FOXF2 decreased significantly.
Higher CD47, LOX and serum Ca 15.3 while lower FOXF2 expression are significantly associated with low survival rate according to KM curve.
6.2 Conclusion
Increased expression of CD47 and LOX genes, while decreased expression of FOXF2 gene are associated with poor prognosis in breast cancer pateints.
CD47 and LOX exert an oncogenic function in breast cancer pateints. However, FOXF2 act as tumor suppressor gene.
Summary, Conclusion and Recommendaions
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Circulating tumor cells CD47 have poor implications in metastatic BC pateints, indicating the potential role of innate and adaptive immune evasion mechanisms in this metastatic potential.
FOXF2 down regulation promotes metastasis in BC pateints.
6.3 Recommendation
Our findings suggest that the potential role of CD47, FOX and LOX as prognostic markers and therapeutic targets.
The result of this study supports the the possibility of use of anti CD47 immunotherapy to treat BMBC pateints.