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Combining nuclear matrix protein-52, collagen III, and matrix metalloproteinase-1 for more effective breast cancer early detection

Aim: Improvement of breast cancer (BrCa) control will be markedly supported by early detection. Owing to limitations of current diagnostic tools like mammography and ultrasound and lack of existing confirmed BrCa biomarkers, this study concerned the evaluation of some potential biomarkers and their combination in BrCa detection. Methods: Three hundred participant women; 200 with BrCa patients, 50 with benign breast diseases, and 50 healthy individuals were enrolled in this study. Serum levels of nuclear matrix protein-52 (NMP-52), collagen III, and matrix metalloproteinase-1 (MMP-1) were determined by ELISA. Results: Mean levels of NMP52 (9.83±1.1 μg/ml), collagen III (22.6±3.2 μg/mL) and MMP-1 (3.6±0.3 μg/mL) in BrCa patients were significantly higher (P<0.0001) than benign (5.8±0.7, 12.2±1.3 and 2.6±0.23 μg/mL, respectively) and healthy (1.2±0.1, 6.0±0.2 and 1.66±0.04 μg/mL, respectively) groups. Also, these levels were associated with the tumor progression and may reflect the BrCa disease severity, high serum levels of these markers have been associated with tumor advanced stages (T3-T4), high grade (G3), and large size (>2cm). Diagnostic scores combined these markers revealed valuable power (AUC=0.83, 78% sensitivity, 75% specificity) in BrCa diagnosis. This power is not markedly influenced in the detection of early tumor stages (Tis-T2), low grade (G1-G2), lesser tumor size ≤2 cm, and negative lymph nodes status (AUC=0.79, 0.74, 0.74, and 0.85, respectively). Conclusions: Combined use of NMP-52, collagen III, and MMP-1 can serve as a potential biomarker for BrCa diagnosis. This combination is likely to improve the clinical early tumor diagnosis.