Diagnostic values of gene expression of cytokeratin - 19 mrna and mammaglobin mrna in breast cancer patients using real-time polymerase chain reaction

ABSTRACT

Breast cancer is the most frequent cancer in women. It constitutes almost 20% of all malignancies in women. Currently it affects approximately 6% of the female population. Even before clinical detection of a primary tumour, cancer cells can invade the adjacent structures from where they travel through lymphatic and blood vessels as circulating tumour cells [CTCs]. CTCs colonize distant organ sites as disseminated tumour cells [DTCs] and eventually form microscopic deposits [micrometastasis < 2 mm in diameter], which may remain dormant, but then ultimately lead to an overt metastatic disease. Cytokeratins [CKs] have become the most widely accepted protein markers for the detection of epithelial tumour cells in mesenchymal tissues, BM, blood and lymph nodes. Based on its breast cancer-association and somewhat unique breast-specific pattern of expression, mammaglobin was believed to be an excellent candidate for a novel and clinically useful breast tumor marker, especially in detecting micrometastasis. This study was performed on one hundred female Individuals. They classified into Group I 20 apparently healthy females as control group. Group II 20 females with stage I breast cancer . Group HI 20 females with stage II breast cancer. Group IV 20 females with stage III breast cancer. Group V 20 females with stage IV breast cancer. The following specific investigations were done for all the studied persons-Cancer Antigen 15-3 [CA15-3] and Carcinoembryonic Antigen [CEA] using chemilmnmescent immunometric assay [IMMULITE 1000 Analyzer]. Cytokeratin-19 mRNA [CK-19] mRNA and mammaglobin mRNA by Real-time polymerase chain reaction [RT-PCR]. In group I [control group] All the 20 healthy control females had low expression values for CK-19 and Mammaglobin. In group 2 [stage I breast cancer] 35% of patients had over expression values for CK-19 and 20% had over expression values for Mammaglobin. In group 3[stage II breast cancer] 47.4% of patients had over expression values for CK-19 and 47.4% had over expression values for Mammaglobin. In group 4 [stage III breast cancer] 68.4% of patients had over expression values for CK-19 and 73.7% had over expression values for Mammaglobin. In group 5 [stage IV breast cancer] 95% of patients had over expression values for CK-19 and 95% had over expression values for Mammaglobin. Our findings support that all patients with breast cancer should be evaluated by CK-19 and Mammaglobin as a regular laboratory assessment beside the routine tumour markers specially in early stages of breast cancer to detect CTCs at the time of diagnosis