title: Serum concentration of tumor necrosis factor in patients with breast cancer.
abstract: BACKGROUND
  The outcome of breast cancer is usually determined by multiple factors. Serum tumor necrosis factor alpha concentration has been found to be increased in the circulation of patients with malignancy. This study was designed with the aim to investigate any correlation between the serum tumor necrosis factor alpha and the clinicopathological features and furthermore evaluate the prognostic significance of serum tumor necrosis factor alpha concentration in breast cancer.
  
  
  METHODS
  Forty consecutive patients with invasive breast cancer undergoing modified radical mastectomy were prospectively included and evaluated. Venous blood samples were collected before the surgery. Sera were obtained by centrifugation, and stored at -70 degrees C until assayed. The control group consisted 30 healthy, age-matched subjects. Serum concentrations of tumor necrosis factor alpha were measured by the quantitative sandwich enzyme immunoassay technique. The data on tumor size, age, estrogen receptor status, lymph node status and TNM staging were reviewed and recorded.
  
  
  RESULTS
  The mean value of serum tumor necrosis factor alpha in patients with invasive breast cancer was 1.47 +/- 0.58 pg/ml and that of the control group was 0.98 +/- 0.37 pg/ml, and the difference was significant (P < 0.01). With univariable analysis, patients with maximum tumor size of 5 cm or larger (P = 0.03), more advanced TNM staging (P < 0.01); and more advanced lymph node status (P < 0.01) were shown to have significantly higher serum concentrations of tumor necrosis factor alpha. However, with multivariable analysis, TNM staging appeared as the only independent factor (P < 0.01) predicting the significant, higher serum concentrations of tumor necrosis factor alpha.
  
  
  CONCLUSIONS
  Preoperative evaluation of serum tumor necrosis factor alpha concentrations may be a valuable parameter for reflecting the severity of staging for invasive breast cancer.
authors.affiliation: Department of Surgery and Pathology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: S M
authors.initials: SM
authors.lastname: Sheen-Chen
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
authors.forename: H L
authors.initials: HL
authors.lastname: Eng
authors.forename: F F
authors.initials: FF
authors.lastname: Chou
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis; D012016:Reference Values; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D011960:Receptors, Estrogen; D014409:Tumor Necrosis Factor-alpha