Background: Serum levels of C-reactive protein (CRP) and orosomucoid are increased in more than one half of patients with metastatic breast cancer. The information concerning their levels in non-metastatic breast cancer is inconclusive. The aim of our study was to examine some acute phase proteins (CRP, orosomucoid, prealbumin, alpha 2-macroglobulin and transferrin) in patients with various clinical stages of breast cancer before hormonal and/or chemotherapy and 3 and 12 months after its institution and to assess the influence of their levels on the outcome of patients.
Methods and results: Altogether 59 women with breast cancer in clinical stage 0-IV, median age 62 years (47 of them after menopause) were examined. One patient was in stage 0, ten patients in stage I, 24 patients in stage IIA, 11 patients in stage IIB, five patients in stage III and eight patients in stage IV. Acute phase proteins (CRP, orosomucoid, transferrin, prealbumin and alpha 2-macroglobulin) were examined in the sera samples using microturbidimetry. Serum levels of CRP and orosomucoid were higher in patients with breast cancer in all stages compared to controls. Serum levels of CRP (resp. of orosomucoid) higher than mean +2 SD had 30.5% (resp. 39%) of patients with breast cancer. One year after the beginning of therapy serum levels of CRP and orosomucoid significantly decreased, however, in case of orosomucoid they remain higher compared to controls. Serum levels of CRP and orosomucoid correlated before therapy in patients with breast cancer one to another and also with serum levels of soluble TNF (tumour necrosis factor) receptor type I and soluble ICAM-1.
In conclusion: Patients with breast cancer before hormonal therapy and/or chemotherapy had compared to controls increased serum levels of CRP and orosomucoid, however, there was no difference between stages I-III. Observed correlation between serum levels of CRP and soluble TNF receptors suggests the important role of proinflammatory cytokines in stimulating their hepatic synthesis also in patients with breast cancer. Putative prognostic role of persistently increased levels of orosomucoid in patients with non-metastatic breast cancer warrants further investigation.