The Preoperative Serum Levels of the Anaphylatoxins C3a and C5a and Their Association with Clinico-Pathological Factors in Breast Cancer Patients

Breast cancer is a common women malignancy worldwide. Emerging evidence suggests that various complement molecules function as an immune suppressors in the tumor microenvironment (TME). Therefore this study aimed to investigate the role of the anaphylatoxins C3a and C5a in the propagation of breast cancer and their relationships with clinicopathological factors in Iraqi women suffering from breast tumors. ELISA technique was used to determine the serum anaphylatoxins C3a and C4a levels in 60 Iraqi women with breast tumors (30 with primary breast cancer and 30 with benign breast tumor) before surgery and treatment as 30 healthy controls. In addition, the clinicopathological factors of all the patients were collected. The result showed a significantly increased level of anaphylatoxins C3a and C5a (P<0.001) in primary breast cancer patients than in benign breast tumor and healthy control women. The area under the curve (AUC) of C3a and C5a for distinguishing patients with primary breast cancer and healthy control subjects was 0.878 (95% CI: 0.768 to 0.948) and 0.953 (95% CI: 0.865 to 0.991) respectively. C5a correlated with larger tumor size, lymph node metastasis, and histologic grade III, whereas C3a only with lymph node metastasis. In conclusion, preoperative levels of C5a exhibit high accuracy for primary breast cancer than C3a. C5a correlated with tumor burden more than C3a and suggested an enhancing effect of C5a on BC proliferation. Thus, suggesting prognostic value for C5a in primary BC.