Association between Preoperative RBC Parameters with Serum VEGF in Women Diagnosed with Breast Carcinoma: A Case-control Study

Abstract

Introduction: The complete blood count is the first investigation to be done in every patient with breast carcinoma before surgery. Vascular Endothelial Growth Factor (VEGF) plays a major role in angiogenesis, metastasis and progression of tumours. Aim: To assess Red Blood Cell (RBC) parameters in breast carcinoma patients and controls, and to evaluate its relation with serum VEGF. Materials and Methods: Present study was a case-control study, conducted in Department of Pathology of JSS Medical College and Hospital, Mysuru, Karnataka, India from November 2019 to April 2021. Preoperative venous blood samples were collected and run in an automated analyser Mindray CAL6000 for all haematological parameters. Preoperative serum samples were collected and serum VEGF was estimated using the Enzyme Linked Immunosorbent Assay (ELISA) method. Statistical analysis was performed with Statistical Package for the Social Sciences (SPSS) version 22.0 to evaluate the association between RBC parameters and serum VEGF using Mann-Whitney U test. Results: A total of 80 samples were evaluated, which included 40 preoperatively diagnosed breast cancer cases and 40 age and sex matched controls. RBC parameters such as RBC, Haemoglobin (Hb), Haematocrit (Hct), red cell indices Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), reticulocytes, Red cell Distribution Width (RDW) and nucleated RBCs (nRBCs) were measured. The nRBCs and serum VEGF of cases were significantly higher than controls. A statistically significant association between patients with low Hb and high serum VEGF was found. Conclusion: A higher percentage of breast carcinoma cases with anaemia in this study was significantly associated with high serum VEGF, reflecting anaemia induced hypoxia may trigger the tumour cells to secrete VEGF.