The evaluation of the inflammatory status and systemic antioxidant-oxidant balance of women with breast cancer during adjuvant chemotherapy

Abstract

Background: Chemotherapy may cause systemic inflammation. Therefore, reliable markers monitoring inflammation during cancer treatment are intensively investigated. In our study, we analyzed the concentration of high-sensitivity C-reactive protein (hs-CRP) and selected oxidative stress markers, such as malondialdehyde (MDA), glutathione peroxidase activity (GPx), and total antioxidant capacity (TAC), in breast cancer women before and during adjuvant chemotherapy.

Materials and methods: The study included 90 women with breast cancer stratified according to clinicopathological and anthropometric features. Blood samples were taken before and after two cycles of adjuvant chemotherapy.

Results: During adjuvant chemotherapy, a significant increase in hs-CRP concentration was noticed in the entire group of patients with breast cancer. After division into appropriate groups, a twofold increase in hs-CRP concentration was particularly observed in patients not expressing steroid hormone receptors and those without metastases in regional lymph nodes. A significant rise in hs-CRP was observed in patients with smaller tumor sizes (2 cm ≤) and with a lower stage of disease [I-IIA according to the tumor-node-metastasis (TNM) classification]. Adjuvant chemotherapy resulted in a significant decrease in GPx activity, especially in patients diagnosed with larger (> 2 cm) and more advanced tumors (IIB-IIIC according to the TNM classification), without metastasis in regional lymph nodes, and without HER-2 expression. A significant decrease in glutathione peroxidase (GPx) activity during adjuvant chemotherapy was also observed in patients with abnormal body mass index (BMI) and body fat content. TAC and MDA values remained unchanged in the entire group of patients and individual subgroups during adjuvant chemotherapy.

Conclusion: Our study showed that adjuvant chemotherapy causes systemic inflammation, manifested by increased hs-CRP and altered markers of oxidative stress in the blood of breast cancer patients. The severity of inflammatory processes during adjuvant chemotherapy may depend on specific characteristics of breast cancer and body composition.

Keywords: adjuvant chemotherapy; breast cancer; glutathione peroxidase; high sensitivity C-reactive protein; inflammation; malondialdehyde; oxidative stress; total antioxidant capacity.

Figure 1

Changes in the concentration of high-sensitivity C-reactive protein (hs-CRP) and selected oxidative stress markers in the entire study group during adjuvant chemotherapy. Results presented as median and interquartile range and analyzed using Wilcoxon test. p ≤ 0.05 was considered statistically significant. GPx — glutathione peroxidase activity; TAC — total antioxidant capacity; MDA — malondialdehyde