الفهرس 
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Abstract
The present study was undertaken to identify postoperative
simple biochemical markers for prediction of bone metastases in Egyptian breast cancer patients. Seventy eight cases with breast cancer (BC) after mastectomy were included. from these patients, 46 had no bone metastasis (NBM) and 32 with radiologically confirmed bone metastasis (BM). Patients with NBM were further observed for a1 year by bone scan in order to monitor development of bone
metastasis (New BM). Nine healthy women with no history
of breast disease or metabolic bone disease were included for
reference ranges. Parameters included full blood picture,
blood tumor markers (carcinoembryonic antigen [CEA] and cancer antigen [CA 15.3]), breast tissue receptor markers
(estrogen receptor [ER], progesterone receptor [PR] and
human epidermal growth factor receptor 2 [HER-2]), together
with blood biochemical markers (tartrate-resistant acid phosphatase [TRAP5b], vascular endothelial growth factor [VEGF], alkaline phosphatase [ALP] and zinc). Analyses showed significantly elevated CEA, ALP, and the
inflammation markers; ALP/monocytes% and
platelet2/(monocytes%+segmented neutrophils%) (P2ms) at
the time of primary diagnosis in patients with BM, compared
to those without BM. Elevated CA 15.3, P2ms, VEGF and
lower monocytes% were independently associated with the
development of New BM (4 patients). The increase in TRAP
activity was related to progesterone receptor expression in breast cancer tissues. In conclusion, this study provides
evidence that circulating markers of cancer; CA 15.3,
vascularization (VEFG/monocytes %) and inflammation (P2ms) markers have the highest prognostic value for predicting development of BM within one year in breast carcinoma patients.