Concentrações salivares e plasmáticas do fator tumoral de necrose alfa e sua correlação com as características clínico-patológicas de pacientes com câncer de mama

Abstract

The tumor necrosis factor alpha (TNF-α) is characterized as one of the most important mediators of the inflammatory response against tumors, including breast cancer. Recent studies have indicated that blood concentrations of TNF-α in different pathological states can also be reflected in salivary secretion. Despite being known for its antitumor effect, TNF-α can act by promoting characteristics of a worse prognosis in breast cancer. Saliva, on the other hand, is a complex biological fluid that contains a variety of enzymes and antibodies, which makes it an alternative source for the search for new biomarkers for tumors, and therefore, a clinically informative and useful fluid for diagnostic approaches and clinical prognosis. It is still unclear whether there is a clinical correlation between circulating TNF-α levels, salivary levels and prognostic parameters in breast cancer. Thus, the objective of this work was to evaluate the relationship between plasma and salivary concentrations of TNF-α in patients with breast cancer and the relationship of these concentrations with the clinical and pathological aspects of patients with breast cancer. This is an exploratory pilot study, which initially included 82 women with suspected breast cancer (BIRADIS IV or V) seen in the public health system within the scope of the 8th Regional Health of Paraná and referred to the Francisco Beltrão Cancer Hospital (Ceonc) between November 2017 and October 2018. After applying the inclusion and exclusion criteria, 49 women who had paired blood and saliva collection were allocated to the groups. Women with benign tumors formed the Control group (n = 29) and those with malignant tumors formed the Cancer (BC) group (n = 20). For both groups, salivary and peripheral blood samples were collected after 12 hours of fasting, and TNF-α was measured by the Human Sandwich Enzyme Immunoassay. The research was approved by the Research Ethics Committee of UNIOESTE under CAAE No. 35524814.4.0000.0107. As a result, the BC group (61.3 + 2.9 years) had a higher average age compared to women in the Control group (32.6 + 2.9 years; p <0.0001). Body weight, height and BMI were similar between groups (p> 0.05). The salivary levels of TNF-α were significantly higher in relation to the plasma concentration in both groups. However, when comparing the Control versus BC groups, neither the plasma levels (p = 0.8017) nor salivary (p = 0.1664) of TNF-α were statistically different. It was not possible to identify a significant association with salivary or plasma levels of TNF-α and age, body weight, height or BMI in patients with BC. In addition, we also demonstrated that plasma salivary and TNF-α levels were not associated with ER biomarkers; PR nor Ki-67. ANOVA test was also used to assess qualitative variables, such as the presence of lymphatic emboli, HER, histological grade and molecular subtype of breast cancer in relation to salivary or plasma levels of TNF-α in the control and BC group. However, no associations were found (p> 0.05). In conclusion, plasmatic or salivary levels of TNF-α were no altered in BC patients, as well as, in both sites the TNF- α no have correlation with classical tumor biomarkers in BC patients.