Abstract

Breast cancer is the commonest site specific malignancy affecting mostly women and the most common cause of cancer mortality in women worldwide. Any kind of severe disease or abnormality (especially cancer) has a direct impact on the host’s immune cells, so it is necessary to investigate the changes in some immunological parameters of breast cancer subjects. This study aimed to assess the degree of derangements of some immunological parameters like CD4,CD8,CD4/CD8 ratio and percentages and a biomarker(anti-HER2 protein IgG) and provide mean +SEM values in breast cancer subjects. This was an observational cross-sectional study among histologically diagnosed breast cancer subjects attending surgery outpatients’ clinic and female surgery ward of University of Port Harcourt Teaching Hospital, Port Harcourt. A Questionnaire was designed to collect information, and data was analyzed using (SAS^R version 9.4).A total of 6.0mls of venous blood was collected from each study participant into EDTA bottles; out of which 3.0mls was used for full blood count, CD4, CD8, absolute counts done on the same day of sample collection. 3.0mls serum of the same blood was used for the analysis of anti-HER2 protein IgG using ELISA method for the determination of the HER2 Receptor status of study participants. A total of 80 subjects;41 histologically diagnosed, consenting breast cancer patients and 39 age- matched (20-70years) staff Medical Laboratory Scientists of the hospital as apparent controls were studied. Demographic characteristics of study participants showed the age group 31-40 had majority of breast cancer 14(17.5%). It was observed that the tribe most affected was the Igbos 33(41.3%). Majority of the study participants were not in their pre-menopausal stage 31(41.9%).  Many were not also on therapy 35(89.7%). Blood group distribution of the study participants showed ABO blood group O, 28(34.2%),and Rhesus D positive,36(43.9%).Chi-square did not reveal any association between blood group and breast cancer.(x²=4-67,p=0.192 and 2-71, p=0-236 respectively. The mean values of the immunological parameters of CD4 and CD8 in the breast cancer subjects were 715.51 ± 51.62 and 386.54 ± 27.50 respectively. These values were significantly lower when compared to 909.37 ± 61.08 and 559.39 ± 43.66 in the control (p=0.018,and p=0.001) respectively. The anti-HER2 protein IgG concentration in the breast cancer subjects was 10.82 ± 1.20 µ/L. This value was found to be significantly lower when compared to 15.69 ± 1.19µ/L in the control subjects (P=0.005). The mean CD4/CD8 % of 33.99 ± 2.65% / 20.94 ± 2.16% in the breast cancer subjects and that of control subjects 35.95 ± 2.16 / 22.46 ± 1.56 % was found not to be statistically significant (P= 0.569). Similarly, the mean CD4/CD8 ratio of 2.11 ± 0.19 in the breast cancer subjects was compared to that of control subjects 1.96 ± 0.15 and was also observed not to be statistically significant (P=0.538). This study revealed that there was evidence of immunological derangement in the breast cancer patients. The anti-HER protein IgG, which measures the status of human epidermal growth factor receptor 2 for breast cancer (one of the breast cancer signaling receptors) was surprisingly significantly elevated in normal controls than the breast cancer patients. Other causes of breast cancer other than HER2 positive status needs to be explored to determine the possible causes of breast cancer in this part of the globe.

Keywords: Immunological, Breast Cancer Patients, University of Port Harcourt Teaching Hospital, Nigeria.