Cancer Antigen 15.3 Levels And Lymphocyte To Monocyte Ratio Of Breast Cancer Subjects receiving Chemotherapy In Umuahia, Nigeria

Abstract

Cancer Antigen 15.3 level (CA 15.3) is used to monitor response to breast cancer treatment and could also be used to survey disease recurrence after treatment of metastatic breast cancer. Lymphocyte-monocyte ratio (LMR), is a reflection of the hosts immunity and its degree of tumor progression. A low lymphocyte count and a high monocyte count indicates that there’s an elevated tumor burden and a poor prognosis for the subject. Aim of the Study: This study is aimed at finding out the levels of Cancer Antigen 15.3 Level and Lymphocyte to monocyte ratio of breast cancer subjects receiving chemotherapy in Umuahia, Nigeria. Materials and Methods: A total of 120 subjects were enrolled in this study. They were aged between 14 and 75 years. Of these 120 subjects, 60 were clinically diagnosed breast cancer subjects, while 60 were apparently healthy subjects. The age range of BRCA subjects were between 14 and 83, the stage of BRCA were from stage I to IV. The haematological parameters were carried out using the five-part Midray BC-5180 haematology analyzer manufactured by the Chinese Midray company. The determination of the CA15.3 levels was done with an Enzyme linked immunosorbent assay (ELISA) machine. The test kit that was used for this test procedure is AccuBind Elisa microwells CA 15-3. Results: From this study, at p<0.05; there was statistically significant increase in WBC (9.3 ± 4.5 x109/L versus 6.8 ± 1.7x109 /L) (p=0.0001), monocyte (7.4 ± 1.8 % versus 3.3 ± 1.1 %)(<0.0001), mean platelet volume (9.0 ± 1.2 fl versus 8.1 ± 0.7 fl)(<0.0001), and CA 15-3 (23.2 ± 8.0 U/ml versus 9.3 ± 5.4 U/ml)(p=<0.0001) in Breast Cancer Patients when compared with control subjects also, significant statistical decrease was observed in eosinophils (1.5 ± 1.6% versus 2.1 ± 1.9%)(p=0.0413), basophils (0.1 ± 0.2 versus 0.5 ± 0.4)(p=<0.0001), RBC (3.5 ± 0.7 x1012/l versus 4.9 ± 0.6 x1012/l)(p=<0.0001), PCV (27.2 ± 6.4 % versus 35.9 ± 3.0 %)(p= <0.0001), PDW (13.5 ± 0.8 versus 17.0 ± 1.7)(p=<0.0001), HB (8.8 ± 2.1g/dl versus 11.9 ± 1.1g/dl)(p=<0.0001), MPV (9.0 ± 1.2fl versus 8.1 ± 0.7 fl)(p=<0.0001), LMR (4.4 ± 2.5 versus 7.7 ± 6.1)(p= 0.0002), in Breast Cancer Subjects, when compared with control subjects. As CA 15.3 is increased in cancer patients, lymphocyte- monocyte ratio LMR is decreased in cancer patients (r = -0.259(P = 0.046), (r=1.000) (p=0.000). Conclusion: There was a negative correlation in cancer antigen 15.3 levels and lymphocyte monocyte ratio as the levels of CA 15.3 were increased while LMR levels were reduced. The subjects in this study had better survival outcomes at the 5th chemotherapy session.