Detection And Significance Of Plasma G-CSF In Patients With Breast Diseases

Backgrounds:Breast cancer is the most common malignant tumor in women worldwide,and its occurrence and development are the result of various factors.Local treatments for breast cancer include surgery and radiotherapy,and systemic treatments include endocrine therapy,chemotherapy,and molecular targeted therapy.In South America,Africa,and Asia,the incidence and mortality of breast cancer are increasing year by year,partly because of lacking state-of-the-art methods of diagnosis and treatment.Therefore,study on scientific and effective breast cancer screening and early diagnosis methods is of great significance.Granulocyte colony-stimulating factor acts on the proliferation,differentiation and migration of neutrophil precursors,which can effectively promote bone marrow hematopoietic function.G-CSF also stimulates the survival and function of mature neutrophils.At present,the recombinant form of human G-CSF is used clinically to prevent and treat neutropenia after tumor chemotherapy or radiotherapy,so as to accelerate recovery and reduce mortality,allowing higher-intensity treat,ment regimens.With the development of research methods and experimental techniques,existing studies have indicated that G-CSF and G-CSFR are expressed in various solid tumors such as gastric cancer,esophageal cancer,colorectal cancer and breast cancer,which can promote tumor progression.However,the results of studies on G-CSF expression and relationship with malignancy are still inconsistent.It is of great value for the early differential diagnosis of benign and malignant breast tumors to study the plasma G-CSF levels in breast tumor patients.Objective:This study aims to detect G-CSF levels in plasma of patients with breast diseases,to explore the correlation between expressions of G-CSF and breast diseases,and to provide evidence for identification of benign and malignant breast diseases and new methods of early diagnosis of breast cancer.Methods:Plasma of 202 female patients with breast diseases who underwent surgery in the breast surgery department of Qilu Hospital of Shandong University from August 2016 to December 2018 were collected.Another 11 healthy women’s plasma were collected as normal control.Plasma G-CSF levels were measured and clinical and pathological data were obtained.SPSS 19.0 statistical software was used for data analysis,Results:1.Sample composition:110 patients with breast cancer,92 patients with benign breast diseases,and 11 healthy controls.There was no significant difference in plasma G-CSF levels between three groups using the Kruskal-Wallis test(P>0.05).2.There was no significant difference in the expression of G-CSF in plasma between different age group,tumor size,ER expression,PR expression,HER-2 expression and lymph node metastasis(P>0.05).3.Using Mann-Whitney test,plasma G-CSF levels in breast cancer patients with Ki-67)14%were significantly higher than those with Ki-67<14%(P=0.008).Correlation analysis was made between plasma G-CSF concentration and immunohistochemical Ki-67 positive rate in breast cancer patients,finding that plasma G-CSF concentration and Ki-67 positive rate were significantly correlated(P=0.018).The Spearman correlation coefficient was 0.225,so plasma G-CSF concentration in breast cancer patients was positively correlated with Ki-67 positive rate.4.Using Kruskal-Wallis test,there was a statistically significant difference in plasma G-CSF levels between four clinico-pathological subtypes of breast cancer patients(P=0.035).Further comparison found that plasma G-CSF level in patients with HER-2 overexpressing breast cancer was significantly higher than plasma G-CSF level in patients with Luminal A breast cancer(P=0.034).The Ki-67 positive rate in Luminal A and HER-2 overexpressing breast cancer patients was further compared.Ki-67 positive rate in HER-2 overexpressing breast cancer patients was significantly higher than that in patients with Luminal A breast cancer(P<0.001).Conclusions:1.Plasma G-CSF levels in breast cancer patients with Ki-67≥14%were significantly higher than those in patients with Ki-67<14%.Plasma level of G-CSF of breast cancer patients was significantly correlated with Ki-67 positive rate,and it was positively correlated.It indicated that human plasma G-CSF level was related to tumor cell proliferation.The faster tumor cells proliferated,the higher plasma G-CSF level was.2.Plasma G-CSF levels of breast cancer patients with different clinico-pathological types were statistically different.The plasma G-CSF level of HER-2 overexpressing breast cancer patients was significantly higher than that of Luminal A breast cancer patients.Further comparison found that Ki-67 positive rate in HER-2 overexpressing breast cancer patients was significantly higher than that in patients with Luminal A breast cancer.It suggested that higher plasma G-CSF level was related to expression of HER-2 gene or the rapid proliferation of tumor cells.3.There was no significant difference in plasma G-CSF levels in breast cancer patients with different age group,tumor size,ER expression,PR expression,HER-2 expression,and lymph node metastasis.4.There was no significant difference in plasma G-CSF levels among benign breast diseases,breast cancer patients,and healthy people.