Midostaurin (PKC412) br The levels of OHdG CA
The levels of 8-OHdG, CA15-3, and CEA were increased in patients with BC with family history of BC and Midostaurin (PKC412) as well, Essam Eldin Mohamed Nour Eldin et al
Table 4 Analysis of Binary Logistic Regression Analysis of Serum 8-OHdG and the Risk of Breast Cancer
95% Confidence Interval
Odds Ratio Significance Lower Upper
Abbreviation: 8-OHdG ¼ 8-hydroxy-2’-deoxyguanosine.
and they increased in the samples with invasive lobular carcinoma more than in the samples with invasive ductal carcinoma (Figure 5).
Correlations of 8-OHdG with CA15-3 and CEA
Diagnostic Performance of Serum 8-OHdG for BC
The analysis of the ROC curve of 8-OHdG serum levels of studied subjects was applied to elucidate the discrimination of the 8-OHdG test between the samples with and without BC. Figure 7 shows the area under the ROC curve. A significant area under the curve (AUC) was observed from the data analysis of the ROC curve (0.86; P < .001). The sensitivity (82%) and specificity (80%) were selected at a cutoff value of 8-OHdG equal to 21.4 ng/mL (Table 3).
Serum 8-OHdG and the Risk of BC
The estimated OR of BC risk was calculated according to quartiles of serum 8-OHdG levels using binary logistic regression analysis. Table 4 show the significant increase by w74 times in the highest quartile group (high-risk) of 8-HOdG levels compared with the lowest quartile group (low-risk). OR was 74.1 (P < .001).
Oxidative stress has been considered as a cause and/or a reason for BC. The extensive damage of DNA leads to the production of oxidative stress at normal physiological conditions.18 One of the most prominent product of oxidative DNA damage is 8-OHdG, which was recently used as a reliable and sensitive marker of oxidative stress and carcinogenesis, and was found in high levels in the biological fluids of several patients with cancer.19
In this study, the levels of 8-OHdG were high in the BC group compared with the benign lesion and healthy control groups, which is compatible with previous published studies.15-17,20 Before tumor removal, 8-OHdG level was higher for breast cancer patient than after tumor removal.21 Additionally, the levels of 8-OHdG were
Table 3 Diagnostic Data of Serum Levels of 8-OHdG Using ROC Curve
Asymptotic 95% Confidence
Cutoff Value, ng/
SE Significance Lower
Upper mL Sensitivity Specificity
Abbreviations: AUC ¼ area under the curve; 8-OHdG ¼ 8-hydroxy-2’-deoxyguanosine; ROC ¼ receiver operating characteristic; SE ¼ standard error.
8-OHdG as Biomarker for Breast Cncer
found to be elevated in patients with BC compared with healthy controls.15 Kuo et al found that the urine levels of 8-OHdG were significantly higher in patients with BC compared with a control group, which supports our findings.15 Berstein et al reported that the serum levels of 8-OHdG increased in patients with BC. The presence of diabetes mellitus (DM) significantly elevated the levels of 8-OHdG in patients with BC with DM compared with those without DM.16 Therefore, it would be important to take into account the status of chronic diseases such as DM, hypertension, and osteoporosis when measuring oxidative stress biomarkers in patients with cancer.
Our study observed a significant gradual decrease in the 8-OHdG levels in invasive BC stages from stage I to stage IV, whereas no significant differences were observed in CA15-3 and CEA levels. These results agree with previous reports that found that expression of 8-OHdG in breast tissues decreased with each stage of breast carcinoma.6,15 Recently, Guo et al have reported that benign lesion and early stage BC could be differentiated by the detection of 8-OHdG.22 Furthermore, the levels of 8-OHdG significantly decreased in invasive breast carcinomas, compared with noninvasive lesions in patients with BC with different degrees of malignancy. These similar data support our results and indicate that 8-OHdG concentrations are strongly dependent on tumor type and stage.23