Tamoksifen tedavisi gören meme kanserli Irak’lı hastalarda serum adenozin deaminaz aktivitesi

Öz

Breast cancer (BC) is a type of cancer originating from breast tissue, Tamoxifen is the usual endocrine therapy for breast cancer in premenopausal women, and also in post-menopausal women. Adenosine deaminase (ADA) is an enzyme involved in purine metabolism, and also increased in most cancers. It is aimed to assess the status of ADA in women with BC on tamoxifen therapy in this study. The present study is a cross-sectional study (2010/2011) done at Al-Kadhumia Teaching Hospital. The procedure includes measurement of ADA in sera of women with BC who were estrogen positive (whether on tamoxifen treatment or not). This measurement was done using ELISA Kit for Adenosine Deaminase (ADA) E91390Hu. A total of 160 patients with BC were involved in this study, they were classified as newly diagnosed premenopausal women with BC G1: (n=40); newly diagnosed postmenopausal women with BC G2: (n=40); Premenopausal women with BC on tamoxifen therapy G3: (n=40); Postmenopausal women with BC on tamoxifen therapy G4: (n=40). A matching group of eighty apparently healthy women who were included as controls (n=80), who were classified as Premenopausal women G5: (n=40); Postmenopausal women with G6: (n=40). Serum ADA was significantly reduced in women with BC receiving tamoxifen therapy when compared with newly diagnosed patients with BC (p < 0.001) and even with controls (p < 0.05). In conclusion, patients with BC have high level of serum ADA compared with controls; however, the level of ADA was significantly reduced upon tamoxifen treatment. The above results were supported by the significant alteration in levels of s. ADA indicating high rate of malignant cell-turn-over resulting in high rate of purine catabolism which is limited by tamoxifine adminstration.

Anahtar Kelimeler

• -

Serum adenosine deaminase activity in Iraqi patients with breast cancer on tamoxifen therapy

Öz

Meme kanseri meme dokusundan kaynaklanan bir kanser tipidir. Tamoksifen hem postmenapozal hem de premenapozal kadınlardaki meme kanserleri için kullanılan yaygın bir endokrin terapisidir. Adenozin deaminaz(ADA) purin metabolizmasında yer alır ve aynı zamanda çoğu kanserde artmıştır. Bu çalışmada tamoksifen terapisi alan meme kanserli hastalardaki ADA durumunu değerlendirilmesi amaçlanmıştır. Mevcut çalışma kesitsel bir çalışma olup 2010-2011 yılları arasında Al-Kadhuma Eğitim Hastanesi’nde yapılmıştır. Bu prosedür östrojen pozitif (tamoksifen tedavisi alan veya almayan) olan meme kanserli hastaların serumlarındaki ADA ölçümünü içermektedir. Bu ölçüm ELISA Kit for Adenosine Deaminase (ADA) E91390Hu kullanılarak yapılmıştır. Toplam 160 hasta çalışmaya dahil edilmiş olup bunlar yeni teşhis edilmiş premenopozal kadınlar BC G1: (n=40); yeni teşhis edilmiş postmenopozal kadınlar BC G2: (n=40); tamoksifen terapisindeki meme kanserli premenopozal kadınlar G3: (n=40); tamoksifen terapisindeki meme kanserli postmenopozal kadınlar G4: (n=40) olarak sınıflandırılmışlardır. Karşılaştırma grubu olarak 80 sağlıklı kadın, kontrol grubu olarak (n=80) çalışmaya dahil edilmiş olup premenopozal kadınlar G5: (n=40); postmenopozal kadınlar G6: (n=40) olarak sınıflandırılmışlardır. Yeni teşhis edilmiş meme kanserli kadınlarla karşılaştırıldığında, serum ADA seviyesi tamoksifen alan hastalarda önemli ölçüde düşmüştü (p

Anahtar Kelimeler

• Adenozin deaminaz, meme kanseri, tamoksifen

Kaynakça

1. 1. Sariego J, Zrada S, Byrd M, Matsumoto T. Breast cancer in the young patient. AM J Surg 1995;170(3):243-5
2. 2. Florescu A, Amir E, Bouganim N, Clemons M. Immune therapy for breast cancer in 2010—hype or hope? Curr Oncol 2011;18(1);e9-e18
3. 3. BIG 1-98 Collaborative Group, Mouridsen H, Giobbie-Hurder A, Goldhirsch A, Thürlimann B, Paridaens R, et al. Letrozole Therapy Alone or in Sequence with Tamoxifen in Women with Breast Cancer. N Engl J Med 2009;361:766-76
4. 4. Wilson DK, Rudolph FB, Quiocho FA. Atomic structure of adenosine deaminase complexed with a transition-state analog: Understanding catalysis and immunodeficiency mutations
5. Science 1991;252(5010):1278-84
6. 5. Cristalli G, Costanzi S, Lambertucci C, Lupidi G, Vittori S, Volpini R, et al. Adenosine deaminase: Functional implications and different classes of inhibitors. Med Res Rev 2001;21(2):105-28
7. 6. Moriwaki Y, Yamamoto T, Higashino K. Enzymes involved in purine metabolism: a review of histochemical localization and functional implications. Histol histopathol 1991;14(4):1321--- 1340
8. 7. Blackburn MR, Kellems RE. Adenosine Deaminase Deficiency: Metabolic Basis of Immune Deficiency and Pulmonary Inflammation. Adv Immunol2005;86:1---41

9. 8. Cowan MJ, Brady RO, Widder KJ. Elevated erythrocyte adenosine deaminase activity in patients with acquired immunodeficiency syndrome. Proc Natl Acad Sci USA 1986;83(4):1089-91
10. 9. Sanchez JJ, Monaghan G, Børsting C, Norbury G, Morling N, Gaspar HB. Carrier frequency of a nonsense mutation in the adenosine deaminase (ADA) gene implies a high incidence of ADA-deficient severe combined immunodeficiency (SCID) in Somalia and a single, common haplotype indicates common ancestry. Ann Hum Genet 2007;71:336---47
11. 10. http://www.uscnk.com/manual/ELISA-Kit-for-Adenosine - deaminase - (ADA) - E91390Hu.pdf (access date 22.09.2012)
12. 11. Chlebowski RT, Kuller LH, Prentice RL, Stefanick ML, Manson JE, Gass M, et al. Breast cancer after use of estrogen plus progestin in postmenopausal women. N Engl J Med 2009 Feb 5;360(6):573-87
13. 12. Suchitra MM, Reddy EP, Sudhakar GM, Ramesh B, Sambasivaiah K, Bitla AR, et al. Evaluation of Serum Adenosine Deaminase as a Tumor Marker in Gastric Cancer
14. Res J Med & Med Sci, 2009;4(2):411-414
15. 13. Hashemi M, Tehrani F, Ghavami S, Sabet M. ADA activity in ER positive and negative breast cancer. MJIRI 2005;19(1):53- 56
16. 14. Aghaei M, Karami-Tehrani F, Salami S, Atri M. Diagnostic value of adenosine deaminase activity in benign and malignantbreast tumors. Arch Med Res 2010;41(1):14-8
17. 15. Shatova OP, Borzenko BG, Zinkovich II, Sedakov IE. Lactate dehydrogenase, adenosine deaminase and thymidine phosphorylase activity of blood and tissues in breast cancer. Ukr Biokhim Zh 2009;81(4):88-93
18. 16. Aghaei M, Karami-Tehrani F, Salami S, Atri M. Adenosine deaminase activity in the serum and malignant tumors of breast cancer: The assessment of isoenzyme ADA1 and ADA2 activities. Clinical Biochemistry 2005;38(10):887-91.