Document Type : Original Article(s)

Authors

1 Department of Radiation Sciences, Medical Research Institute, Alexandria University, Alexandria, Egypt

2 Department of Experimental and Clinical Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt

3 Department of Cancer Management and Research, Medical Research Institute, Alexandria University, Alexandria, Egypt

10.30476/mejc.2023.98136.1886

Abstract

Background: Traditional tumor markers such as cancer antigen 15.3 (CA15.3) and carcinoembryonic antigen (CEA) exhibit limited clinical utility in breast cancer due to their lack of sensitivity and specificity, particularly for detecting low-volume tumors. Other serum markers, such as nestin, may offer more promise. This study aimed to assess the clinical significance of serum nestin and CA15.3 in breast cancer patients.
Method: This case-control study enrolled 80 normal control females and 80 females with breast cancer. Serum samples were collected from both control and breast cancer groups. The serum nestin and CA15.3 levels were measured in all samples using enzyme-linked immunosorbent assay (ELISA) kits.
Results: The serum levels of nestin and CA15.3 were found to be significantly elevated in the breast cancer patient group compared with the control group. Preoperative serum nestin levels exceeding 9.9 ng/ml demonstrated a substantial odds ratio of 27 (confidence interval: 4.57-159.67; P = 0.0003). In receiver operating characteristic (ROC) curve analysis, serum nestin exhibited the highest significant area under the curve (AUC) at 85.2% (P = 0.000*), followed by serum CA15.3 at 70% (P = 0.021*). Post-surgery serum nestin levels significantly decreased compared with pre-surgery levels (P = 0.045*).
Conclusion: Serum nestin outperforms serum CA15.3 in diagnosing breast cancer patients. Elevated serum nestin levels may represent a significant risk factor for the development of breast cancer. Furthermore, serum nestin can monitor the effects of surgery, whereas none of the assessed biomarkers exhibit a significant role in monitoring the effects of chemotherapy on breast cancer patients.

Highlights

Taha I. Hewala (Google Scholar)

Keywords

Main Subjects

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination, and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.30476/mejc.2023.98136.1886

MarconiR, SerafiniA, Giovanetti A, BartoleschiC, PardiniMC, Gianluca BossiG, et al. Cytokine modulation in breast cancer patients undergoing radiotherapy: A revision of the most recent studies. Int J Mol Sci. 2019;20(2):382. doi: 10.3390/ijms20020382. Svobodova S, Kucera R, Fiala O, Karlikova M, Narsanska A, Zedníková I, et al. CEA, CA 15-3, and TPS as prognostic factors in the follow-up monitoring of patients after radical surgery for breast cancer. Anticancer Res. 2018;38(1):465-9. doi: 10.21873/anticanres.12245. Fu Y, Li H. Assessing clinical significance of serum CA15-3 and carcinoembryonic antigen (CEA) levels in breast cancer patients: a meta-analysis. Med Sci Monit. 2016;22:3154-62. doi:10.12659/msm.896563 Kabel AM. Tumor markers of breast cancer: New prospectives. Journal of Oncological Sciences. 2017;3:5-11. doi:10.1016/j.jons.2017.01.001. Nowak A, Dziegiel P. Implications of nestin in breast cancer pathogenesis (Review). Int J Oncol. 2018;53(2):477-87. doi: 10.3892/ijo.2018.4441. Neradil J, Veselska R. Nestin as a marker of cancer stem cells. Cancer Sci. 2015;106(7):803-11. doi: 10.1111/cas.12691. Sharma P, Alsharif S, Fallatah A, Chung BM. Intermediate filaments as effectors of cancer development and metastasis: a focus on keratins, vimentin, and nestin. Cells. 2019;8(5):497. doi: 10.3390/cells8050497. Zhang X, Xing C, Guan W, Chen L, Guo K, Yu A, et al. Clinicopathological and prognostic significance of Nestin expression in patients with breast cancer: a systematic review and meta-analysis. Cancer Cell Int. 2020;20:169. doi: 10.1186/s12935-020-01252-5. Meisen WH, Dubin S, Sizemore ST, Mathsyaraja H, Thies K, Lehman NL, et al. Changes in BAI1 and Nestin expression are prognostic indicators for survival and metastases in breast cancer and provide opportunities for dual targeted therapies. Mol Cancer Ther. 2015;14(1): 307-14. doi: 10.1158/1535-7163.MCT-14-0659. Paluch-Shimon S, Pagani O, Partridge AH, Bar-Meir E, Fallowfield L, Fenlon D, et al. Second international consensus guidelines for breast cancer in young women (BCY2). Breast. 2016;26:87-99. doi: 10.1016/j.breast.2015.12.010. National Comprehensive Cancer Network (NCCN): NCCN Clinical practice Guidelines in Oncology (NCCN Guidelines). Breast Cancer. Version 5.2020. July 2020. NCCN guidelines for patients®. Available at: www.nccn.org/patients De Lara S, Nyqvist J, Werner Rönnerman E, Helou K, Kenne Sarenmalm E, Einbeigi Z, et al. The prognostic relevance of FOXA1 and Nestin expression in breast cancer metastases: a retrospective study of 164 cases during a 10-year period (2004-2014). BMC Cancer. 2019;19(1):187. doi: 10.1186/s12885-019-5373-2. Sal V, Kahramanoglu I, Bese T, Demirkiran F, Sofiyeva N, Soyman Z, et al. Is serum level of Nestin useful in detecting epithelial ovarian cancer? J Obstet Gynaecol Res.2017; 43(2):371-7. doi: 10.1111/jog.13220. Aglan SA, Elsammak M, Elsammak O, El-Bakoury EA, Elsheredy HG, Ahmed YS, et al. Evaluation of serum Nestin and HOTAIR rs12826786 C>T polymorphism as screening tools for breast cancer in Egyptian women. J Med Biochem. 2021;40(1):17-25. doi: 10.5937/jomb0-25295. Matsuda Y, Hagio M, Ishiwata T. Nestin: a novel angiogenesis marker and possible target for tumor angiogenesis. World J Gastroenterol. 2013;19(1):42-8. doi:10.3748/wjg.v19.i1.42 Mohammed FZ, Gamal L , Mosa MF, Aref MI. Assessment of CA15-3 and CEA as potential markers for breast carcinoma prognosis in Egyptian females. Alfarama Journal of Basic & Applied Sciences (AJBAS). 2021;2(1):44-50. doi:10.21608/AJBAS.2020.32631.1018. Moazzezy N, Farahany TZ, Oloomi M, Bouzari S. Relationship between preoperative serum CA15-3 and CEA levels and clinicopathological parameters in breast cancer. Asian Pac J Cancer Prev. 2014;15(4):1685-8. doi: 10.7314/apjcp.2014.15.4.1685. Hewala TI, Abd El-Monaim NA, Anwar M, Ebied SA. The clinical significance of serum soluble Fas and p53 protein in breast cancer patients: comparison with serum CA 15-3. Pathol Oncol Res. 2012;18(4):841-8. doi: 10.1007/s12253-012-9512-1. Fejzić H, Mujagić S, Azabagić S, Burina M. Tumor marker CA 15-3 in breast cancer patients. Acta Med Acad. 2015;44(1):39-46. doi: 10.5644/ama2006-124.125. Ali HQ, Mahdi NK, Al-Jowher MH. The value of CA15-3 in diagnosis, prognosis and treatment response in women with breast cancer. J Pak Med Assoc. 2013;63(9):1138-41. Yang Y, Zhang H, Zhang M, Meng Q, Cai L, Zhang Q. Elevation of serum CEA and CA15-3 levels during antitumor therapy predicts poor therapeutic response in advanced breast cancer patients. Oncol Lett. 2017;14(6):7549-56. doi: 10.3892/ol.2017.7164.