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A new approach to lymphedema following breast cancer treatment with lymphatic endothelial cell markers

Cite this article as : Nurlu N, Bulut GT. A new approach to lymphedema following breast cancer treatment with lymphatic endothelial cell markers. J Health Sci Med 2021; 4(3): 322-328. ABSTRACT Aim: Lymphedema (LE) is a common iatrogenic complication of breast cancer treatment that may occur following axillary lymph node dissection and radiotherapy. In this study, we aimed to investigate the serum levels of the lymphatic endothelial cell spesific (LECs) markers; homeobox transcription factor (Prox-1), lymphatic vessel endothelial receptor-1 (LVYE-1), and podoplanin (PDPN) in patients with LE following breast cancer treatment. Material and Method: In total, 44 female patients who developed LE in an upper extremity after breast cancer treatment constituted the study’s LE group, and 44 healthy women constituted the control group. Patients’ arm circumferences were measured, and the differences between the sums of arm circumferences (DSOAC) were accepted as indicating LE when the difference was 2 cm or 10%. Serum Prox-1, LVYE-1,PDPN concentrations were measured using commercial enzyme-linked immunosorbent assay (ELISA). Results: Prox-1, LVYE-1, and PDPN levels were significantly lower in the LE group than in the control group (p<0.01, p=0.02, p=0.04, respectively). Prox-1 levels were found to be significantly higher in patients with Stage 1 LE than those with Stage 2 (p<0.001). There was a weak negative correlation between Prox-1 levels and DSOAC and number of axillar lymph node removed (NALNR) levels (r=−0.417 and −0.426, respectively; p<0.01), and a moderate positive correlation between DSOAC and NALNR (r=0.533, p<0.001). Conclusion: Prox-1, LVYE-1, and PDPN levels decrease in secondary LE. Further investigations of LEC markers may aid the development of new perspectives on LE diagnosis, prognosis, and treatment.