The Study of Some biochemical markers associated with prognosis of Breast cancer in Iraqi women

Hussein Salim Sakhi 1, Haider Abed Zaid Jassim 2, Alaa fahim jasim 3.

Abstract

Prediction of treatment outcome in patients with advanced breast cancer remains a challenge. Even within the same stage, survival and response vary, so the goal of This study was to evaluate the prognostic value of systemic inflammatory markers available in the general laboratory: C-reactive protein (CRP), D-dimer (DD), Porcalcitonin (PC) and Erythrocyte sedimentation rate (ESR) in patients with breast cancer.

Methods: Retrospective cohort study carried out between January 1, 2022 and May 31, 2023 with a total of 98 with patients with different stage of breast cancer. From which the levels of the inflammatory markers CRP, DD, PC and ESR were obtained prior to the first line of chemotherapy, and at the time of evaluation of the response to management. The study evaluate the correlation of basal levels and their variation with the response to treatment, progression-free survival (PFS) and overall survival (OS). The value of a combined index (CRP + ESR) in prognosis was also assessed.

Results: 98 patients with a mean age of 55 years (SD ± 12) were included; 70% were women, 83% had adenocarcinoma, 47% had more than two organs involved by metastasis and 89% had an IK > 70%. At the start of chemotherapy, 52%, 43%, 53% and 34% had abnormal levels of PC, DD, ESR and CRP, respectively. Patients with low ESR (p = 0.004), high DD (p = 0.012) and abnormal CRP (p = 0.040) had a worse overall response rate to chemotherapy From first line. In the bivariate analysis, patients with elevated CRP (HR 1.67; 95% CI: 1.28-2.69; p = 0.008) and DD (HR 2.56, 95% CI: 01.05-03.04, p = 0.006) had inferior PFS; Likewise, patients with high CRP (HR 1.9, 95% CI: 01.04- 02.01, p = 0.04) and low albumin levels (HR 2.9, 95% CI: 2.1-4.6, p = 0.03) had worse OS. In the multivariate analysis, both albumin and CRP were independent prognostic factors for survival.