Assessing angiogenesis factors as prognostic biomarkers in breast cancer patients and their association with clinicopathological factors

Abstract

Introduction

Angiogenesis is fundamental for tumor growth and metastasis across many solid malignancies. Considerable interest has focused on the molecular regulation of tumor angiogenesis as a means to predict disease outcomes and guide therapeutic decisions.

Methods

In the present study, we investigated the prognostic value of transforming growth factor beta (TGF-β), epidermal growth factor (EGF), fibroblast growth factor (FGF), delta-like ligand 4 (DLL4), and vascular endothelial growth factor (VEGF) in the serum of 120 women diagnosed with breast cancer using ELISA as well as examined their associations with clinical parameters and the outcome of the disease.

Results

Our results demonstrated that the serum concentration of TGF-β and EGF were remarkably higher in patients with higher tumor size, end stages of the disease, and positive lymph node involvement compared to patients with lower tumor size, early stages of the disease, and negative lymph node involvement. In addition, we found a significant correlation between the serum concentration of VEGF and the level of EGF, FGF, and DLL4 in patients with breast cancer. Furthermore, both univariate and multivariate analyses showed that TGF-β and EGF can be used as end-stage predictors.

Discussion/Conclusion

Based on our findings, increasing the level of angiogenesis factors is significantly associated with higher tumor size and late stages of the disease in patients with breast cancer. Moreover, measuring the level of angiogenesis factors could lead to better prediction of disease outcomes and choosing the best treatments for patients.

Keywords:

• Breast cancer
• VEGF
• FGF
• EGF
• TGF-β
• DLL4

Acknowledgements

We would like to thank the Rasoul-Akram and Khatam-al-Anbya hospitals; and Clinical Research Development Unit of Kowsar Educational and Research and Therapeutic Center of Semnan University of Medical Sciences for providing facilities for this work.

Ethical approval

The study complied with the guidelines for human studies and was conducted by the World Medical Association Declaration of Helsinki. The study protocol was approved by the Ethical Board of the Semnan University of Medical Sciences (IR.SEMUMS.REC.1401.303). Written informed consent to participate in the study and publication of their clinical details was obtained from all participants.

Author contributions

Rasoul Baharlou and Nahid Nafissi conceived and planned the experiments. Rasoul Baharlou and Maryam Sheikh carried out the experiments. Tannaz Abbasi-Dokht wrote the manuscript. Nahid Nafissi, Farhad Malek, Sedigheh Akbari, and Mohammad Hossein Zargaran contributed to sample preparation. Rasoul Baharlou, Tannaz Abbasi-Dokht, and Maryam Mohammadlou contributed to the interpretation of the results. All authors provided critical feedback and helped shape the research, analysis, and manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.

Additional information

Funding

This work was supported by a grant from Semnan University of Medical Sciences (No. 1592).