Full Blood Count and Cancer Antigen 15.3 Levels of Breast Cancer Subjects in Umuahia, Abia State, Nigeria

Abstract

Full blood count which is measurable indices of blood gives the total number and morphology of all the cellular component of the blood and is an important tool in disease diagnosis and monitoring of treatment. Cancer antigen 15.3 (CA 15.3) levels are mostly recommended for patients with metastatic breast cancer that are undergoing treatment therapy to monitor their tumor and check if the tumor is responding to the treatment therapy. It could also be used to survey disease recurrence after treatment of metastatic breast cancer. Aim: The aim of this study is to evaluate full blood count and cancer antigen 15.3 levels of breast cancer subjects in Umuahia, Abia State, Nigeria. Study Design: A case-control study design was used in this study. Place and Duration of study: Study was carried between May 2023 to October 2023 at the surgery department of federal medical center umuahia, Abia state, Materials and Methods: A total of 120 subjects aged between 14 to 75 years were enrolled in this study. Of this 120 subjects, 60 were clinically diagnosed breast cancer patients while 60 were apparently healthy subjects. The breast cancer (BRCA) subjects were classified into stage I to IV of which 5 subjects (8.33%) were in Stage I, 14 subjects (23.33%) were in Stage II, 23 subjects (38.33%) were in Stage III and 18 subjects (30%) were in Stage IV. The haematological parameters were carried out using the five-part Mindray BC-5180 Haematology autoanalyzer manufactured by the Chinese Mindray company. The determination of the CA15.3 levels was done using enzyme linked immunosorbent assay (ELISA) technique. Data were analyzed using Graph Pad Prism version 8.2 and descriptive statistics was used for mean and standard deviation while Inferential statistics was used for students t-test, ANOVA and correlation. Statistical significance was set at 95% confidence interval (p≤0.05). Results:  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) and mean platelet volume (9.0 ± 1.2 fl versus 8.1 ± 0.7 fl) (<0.0001) in breast cancer patients when compared with control subjects. There was however  statistically significant decrease 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) and LMR (4.4 ± 2.5 versus 7.7 ± 6.1)(p= 0.0002) in breast cancer patients when compared with control subjects . Other haematological parameters like neutrophils, lymphocytes, MCV, MCH, MCHC and platelets did not show any statistical significant difference. There was statistically significant increase in cancer antigen 15.3 levels in breast cancer patients when compared with control subjects (23.2 ± 8.0 U/ml versus 9.3 ± 5.4 U/ml) (p=<0.0001). Conclusion: This study has established that cancer antigen 15.3 levels, does not really show the severity of breast cancer in a subject. Although high levels of cancer antigen levels were seen in the diseased individuals, but one would expect that in patients with advanced stages, very high levels of CA15-3 will be observed, but it was not so, in this study. Also this study established that, chemotherapy sessions are important for quick recovery as it was seen in this study, the subjects were not consistent with their sessions, which led to poor prognosis for most of them.