title: Evaluation of inflammatory biomarkers as helping diagnostic tool in patients with breast cancer.
abstract: OBJECTIVE
  The aim of this study was to evaluate the serum levels of IFN-γ, IL-18, NO and MDA, in patients with breast cancer and to assess their clinical significance as a novel diagnostic markers in breast carcinoma.
  
  
  METHODS
  We examined IFN-γ, IL-18, NO and MDA in 18 healthy volunteers, 38 patients with primary invasive breast cancer, and 18 patients with distant metastatic breast cancer. Serum levels of NO were measured by the Griess method. Serum concentrations of IFN-γ and IL-18 were analyzed with ELISA assays. Concentration of MDA in serum was measured by a thiobarbituric acid assay. The diagnostic value of inflammatory biomarkers was evaluated by receiver operating characteristic curves (ROC) and logistic regression models.
  
  
  RESULTS
  ROC curve analyses demonstrated that only IFN-γ has the ability to distinguish either presence of breast cancer or breast cancer in localized or metastatic form, whereas IL-18 and NO can detect only metastasis. Using a logistic regression model with IL-18 and MDA we obtained a higher sensitivity and specificity regardless of disease status. A panel combining four markers, at least one "rule", achieved the highest sensitivity of 95% and 100% for localized and metastatic cancer, respectively, and high specificity of 80%.
  
  
  CONCLUSIONS
  The combination of four inflammatory biomarkers could be a novel panel of diagnostic markers in patients with breast cancer.
authors.affiliation: Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Pubic Health Institute Kragujevac, Kragujevac, Serbia.
authors.forename: Dejan
authors.initials: D
authors.lastname: Baskic
authors.affiliation: Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors.forename: Suzana
authors.initials: S
authors.lastname: Popovic
authors.affiliation: Faculty of Mathematics and Natural Sciences, University of Kragujevac, Kragujevac, Serbia.
authors.forename: Dragic
authors.initials: D
authors.lastname: Bankovic
authors.affiliation: Institute of Medical Microbiology and Immunology, Medical Faculty, University of Pristina, Kosovska Mitrovica, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Arsovic
authors.affiliation: Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors.forename: Vuk
authors.initials: V
authors.lastname: Vukovic
authors.affiliation: Department of Biochemistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors.forename: Ivanka
authors.initials: I
authors.lastname: Zelen
authors.affiliation: Hematology Clinic, Clinical Center Kragujevac, Kragujevac, Serbia.
authors.forename: Predrag
authors.initials: P
authors.lastname: Djurdjevic
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics*; D001943:Breast Neoplasms / Q000097:blood* / Q000235:genetics* / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology; D007371:Interferon-gamma / Q000097:blood; D020382:Interleukin-18 / Q000097:blood; D008315:Malondialdehyde / Q000097:blood; D009569:Nitric Oxide / Q000097:blood*; D012372:ROC Curve
chemical_list: D014408:Biomarkers, Tumor; D020382:Interleukin-18; D009569:Nitric Oxide; D008315:Malondialdehyde; D007371:Interferon-gamma
keywords: Interferon-gamma; interleukin-18; malonyl-dialdehyde; nitric oxide; receiver operating characteristic