Abstract
Breast cancer is by far the most common cancer in women worldwide and the main cause of cancer-related mortality. Breast cancer accounts for 38% of all malignancies among Egyptian women. The aim of our study was to evaluate the serum levels of human epidermal growth factor receptor-2 (HER2), matrix metalloproteinase-9 (MMP-9), nitric oxide (NO), and total antioxidant capacity (TAC) in breast cancer patients and to correlate these markers with clinico-pathological parameters. Serum HER2, MMP-9, and carcinoma antigen 15-3 (CA 15-3) were assessed in 80 breast cancer patients and ten healthy subjects as a control group by the enzyme-linked immunosorbent assay (ELISA) technique while NO and TAC were assessed by a colorimetric method. Serum HER2 was ≥15 ng/mL in nine patients (11.3%). High HER2 ECD levels were significantly associated with tissue HER2 (P<0.0001), metastasis (P= 0.0024), and negativity of both estrogen (P=0.0075) and progesterone (P=0.0239) receptors. Serum MMP-9 (P=0.0013), NO (P<0.0001), and CA 15-3 (P<0.0001) were significantly increased while serum TAC was significantly (P=0.01) decreased in breast cancer patients as compared to the control group. Serum MMP-9 was increased significantly (P=0.028) in metastatic patients as compared to non-metastatic patients. We found a positive correlation between serum HER2 and CA 15-3 (r=36, p=0.005). In conclusion, serum HER2 reflects the tissue HER2 status of breast cancer, so the determination of serum HER2 is helpful in assessing HER2 status, but in addition, a high level may reflect metastatic disease. Also, serum MMP-9 can be useful for denoting the development of metastasis in breast cancer patients. Follow-up is needed to evaluate the value of serum HER2 and MMP-9 as prognostic markers.
Highlights
Breast cancer is by far the most common cancer in women worldwide and the main cause of cancer-related mortality [1]
Serum human epidermal growth factor receptor-2 (HER2) reflects the tissue HER2 status of breast cancer, so the determination of serum HER2 is helpful in the assessment of the HER2 status, but in addition a high level may reflect metastatic disease
Serum matrix metalloproteinase-9 (MMP-9) can be useful for denoting the development of metastasis in breast cancer patients
Summary
Breast cancer is by far the most common cancer in women worldwide and the main cause of cancer-related mortality [1]. In Egypt, as in many other parts of the world, breast cancer is the most common type of cancer: it accounts for approximately 38% of reported malignancies among Egyptian women [2]. The human epidermal growth factor receptor (HER)-2 (HER2/neu, c-erbB-2) is a transmembrane receptor that is overexpressed in 15–25% of breast cancers. HER2 overactivity is associated with adverse biological characteristics and poor clinical outcomes. It is an attractive target for therapeutic intervention, a strategy that has been clinically validated [3]. The serum extracellular domain fragment of HER2 (HER2 ECD) represents a non-invasive and quantifiable biomarker that could supplement existing HER2/neu testing [6]
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