Association between serum TNF-α level with the incidence of metastases in women with breast cancer in Dr. Soetomo General Hospital, Indonesia

Rachman Efendi; Husnul  Ghaib; Iskandar Ali

doi:10.15562/bmj.v11i3.3611

Association between serum TNF-α level with the incidence of metastases in women with breast cancer in Dr. Soetomo General Hospital, Indonesia

Rachman Efendi ,

Husnul Ghaib ,

Iskandar Ali ,

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DOI: https://doi.org/10.15562/bmj.v11i3.3611 |
Published: 2022-11-13

Abstract

Abstract

Background: Breast cancer is the most common cancer in women. The occurrence of metastasis in breast cancer should be detected early. Tumor necrosis factor-α (TNF-α) is involved in every step of the carcinogenesis process. A rise in TNF-α level is linked to the advancement of breast cancer. We aimed to determine the association between TNF-α levels and breast cancer metastases.

Methods: An analytic cross-sectional study was conducted on women with breast cancer treated at the Oncology Surgery Center between November 2021 and April 2022. The patient's data were collected from the medical record, including age, menopausal status, tumor size and lymph node involvement, and tumor subtype. The serum TNF-α level was measured using ELISA. The optimal cut-off value was determined using the receiver operating characteristics analysis. The association between serum TNF-α and the incidence of breast cancer metastases was analyzed using SPSS version 26 for Windows.

Results: We analyzed a total of 50 patients. The mean age was 48.8 ± 8.3 years. The serum TNF-α level was divided into high-TNF-α and low-TNF-α using a cut-off value of 22.755 pg/mL. There were 27 patients (27/50; 54.0%) with high serum TNF-α levels and 23 patients (23/50; 46.0%) with low TNF-α levels. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 73.9%, 63.0%, 63,0%, 73,9%, and 68%, respectively. There was a statistically significant association between serum TNF-α levels and metastatic breast cancer (p=0.009).

Conclusion: There was a significant association between TNF-α levels and metastatic breast cancer. Serum TNF-α may be a potential biomarker to detect metastasis in breast cancer patients.

References

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Solikhah S, Lianawati L, Matahari R, Rejeki DSS. Determinants of Breast Cancer Screening Practice among Women in Indonesia: A Nationwide Study. Asian Pac J Cancer Prev. 2021;22(5):1435–1441.
Hidayat YH, Ishardyanto H, Anniwati L. High Sensitive Troponin I and Extended Range C-Reactive Protein as Markers to Predict Cardiotoxicity in Locally Advanced Breast Cancer with Neoadjuvant CAF (Cyclophoshpamide, Adriamycin/Doxorubicin, 5Fluorouracil) Therapy. Folia Medica Indones. 2020;6:56(2):91–98.
Vidiyanti C, Fauziah D, Suprabawati DGA. ER, PR, and HER-2/NEU Profile on Young Breast Cancer Carcinoma Patients. Folia Medica Indones. 2014;50(1):1-10.
Winters S, Martin C, Murphy D, Shokar NK. Breast Cancer Epidemiology, Prevention, and Screening. Prog Mol Biol Transl Sci. 2017;151:1-32.
Dillekås H, Rogers MS, Straume O. Are 90% of deaths from cancer caused by metastases? Cancer Med. 2019;8(12):5574–5576.
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Mercogliano MF, Bruni S, Elizalde P V., Schillaci R. Tumor Necrosis Factor α Blockade: An Opportunity to Tackle Breast Cancer. Front Oncol. 2020;10:584.
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[1] Agustina J, Sinulingga D, Suzanna E, Andinata B, Ramadhan R, Kadir A. Epidemiology of Female Breast Cancer in West Jakarta, Indonesia. J Glob Oncol. 2018;4(Suppl 2):65s-65s.

[2] Gondhowiardjo S, Christina N, Ganapati NPD, Hawariy S, Radityamurti F, Jayalie VF, et al. Five-Year Cancer Epidemiology at the National Referral Hospital: Hospital-Based Cancer Registry Data in Indonesia. JCO Glob Oncol. 2021;7:190–203.

[3] Solikhah S, Lianawati L, Matahari R, Rejeki DSS. Determinants of Breast Cancer Screening Practice among Women in Indonesia: A Nationwide Study. Asian Pac J Cancer Prev. 2021;22(5):1435–1441.

[4] Hidayat YH, Ishardyanto H, Anniwati L. High Sensitive Troponin I and Extended Range C-Reactive Protein as Markers to Predict Cardiotoxicity in Locally Advanced Breast Cancer with Neoadjuvant CAF (Cyclophoshpamide, Adriamycin/Doxorubicin, 5Fluorouracil) Therapy. Folia Medica Indones. 2020;6:56(2):91–98.

[5] Vidiyanti C, Fauziah D, Suprabawati DGA. ER, PR, and HER-2/NEU Profile on Young Breast Cancer Carcinoma Patients. Folia Medica Indones. 2014;50(1):1-10.

[6] Winters S, Martin C, Murphy D, Shokar NK. Breast Cancer Epidemiology, Prevention, and Screening. Prog Mol Biol Transl Sci. 2017;151:1-32.

[7] Dillekås H, Rogers MS, Straume O. Are 90% of deaths from cancer caused by metastases? Cancer Med. 2019;8(12):5574–5576.

[8] Nakahara H, Namba K, Wakamatsu H, Watanabe R, Furusawa H, Shirouzu M, et al. Extension of breast cancer: comparison of CT and MRI. Radiat Med. 2002;20(1):17–23.

[9] Wei B, Wang J, Bourne P, Yang Q, Hicks D, Bu H, et al. Bone metastasis is strongly associated with estrogen receptor-positive/progesterone receptor-negative breast carcinomas. Hum Pathol. 2008;39(12):1809–1815.

[10] Mercogliano MF, Bruni S, Elizalde P V., Schillaci R. Tumor Necrosis Factor α Blockade: An Opportunity to Tackle Breast Cancer. Front Oncol. 2020;10:584.

[11] Libson S, Lippman M. A review of clinical aspects of breast cancer. Int Rev Psychiatry. 2014;26(1):4–15.

[12] Kolak A, Kamińska M, Sygit K, Budny A, Surdyka D, Kukiełka-Budny B, et al. Primary and secondary prevention of breast cancer. Ann Agric Environ Med. 2017;24(4):549–553.

[13] Fu J, Wu L, Xu T, Li D, Ying M, Jiang M, et al. Young-onset breast cancer: A poor prognosis only exists in low-risk patients. J Cancer. 2019;10(14):3124–3132.

[14] Devi DG, Ishardyanto H. Young Age Breast Cancer: Profiles and Overall Survival in Dr. Soetomo Oncology Center, Surabaya, Indonesia. EJSO. 2020;46(2):63–64.

[15] Hamajima N, Hirose K, Tajima K, Rohan T, Friedenreich CM, Calle EE, et al. Menarche, menopause, and breast cancer risk: Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol. 2012;13(11):1141–1151.

[16] Surakasula A, Nagarjunapu G, Raghavaiah K. A comparative study of pre- and post-menopausal breast cancer: Risk factors, presentation, characteristics and management. J Res Pharm Pract. 2014;3(1):12-18.

[17] Narod SA. Tumour size predicts long-term survival among women with lymph node-positive breast cancer. Curr Oncol. 2012;19(5):249–253.

[18] Teichgraeber DC, Guirguis MS, Whitman GJ. Breast cancer staging: Updates in the AJCC cancer staging manual, 8th edition, and current challenges for radiologists, from the AJR special series on cancer staging. Am J Roentgenol. 2021;217(2):278–290.

[19] Winantyo VI, Tanggo VVCM, Ali I. Association of neutrophil-lymphocyte ratio (NLR) with the anthracycline-based neoadjuvant chemotherapy (NAC) clinical response in locally advanced breast cancer (LABC) in young women. Bali Medical Journal. 2022;11(2):602-608.

[20] Zhang Z, Lin G, Yan Y, Li X, Hu Y, Wang J, et al. Transmembrane TNF-alpha promotes chemoresistance in breast cancer cells. Oncogene. 2018;37(25):3456–3470.

[21] Devi DGAP, Purwanto H, Sandhika W. Changes in Ki67 expression and clinical response to neoadjuvant chemotherapy in locally advanced breast cancer (LABC). Bali Medical Journal. 2021;10(3):925–931.

[22] Sheen-Chen S-M, Chen W-J, Eng H-L, Chou F-F. Serum concentration of tumor necrosis factor in patients with breast cancer. Breast Cancer Res Treat. 1997;43(3):211–215.

[23] Tripsianis G, Papadopoulou E, Anagnostopoulos K, Botaitis S, Katotomichelakis M, Romanidis K, et al. Coexpression of IL-6 and TNF-α: prognostic significance on breast cancer outcome. Neoplasma. 2014;61(2):205–212.

Association between serum TNF-α level with the incidence of metastases in women with breast cancer in Dr. Soetomo General Hospital, Indonesia

Abstract

References

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