Multiple biomarker panel for the detection of circulating tumor cells in peripheral blood of breast cancer patients for early detection using the real-time reverse transcription-polymerase chain reaction

BACKGROUND: Circulating cells are epithelial cells that are detectable in the blood of breast cancer patients and the pattern of genes expression in these cells is different from that of the blood cells. However, their role in the early diagnosis of breast cancer has not yet been fully elucidated. One way of detecting these cells is through the use of molecular markers. Therefore, in this study, the presence of 5 specific genes was identified. METHODS: The expression of CK19-CK20-Maspin-Survivin-Ephb4 genes was done on 5 cell lines and peripheral blood samples from 30 breast cancer patients who had not yet entered the untreated phase using real-time polymerase chain reaction. Moreover, 30 healthy individuals were assigned to the control group. RESULTS : When only one gene was involved, the highest and lowest values of sensitivity were observed in Survivin (90%) and CK20 (40%) respectively. In addition, the highest and lowest specificity values were observed in CK 19 (90%) and Ephb4 (40%) respectively. But when the expression of all five genes was done simultaneously, the level of specificity increased to 100%, even though a sharp decrease was observed in sensitivity. CONCLUSIONS: In order to detect circulating tumor cells, evaluating the expression of a gene cannot be helpful. However, the use of biomarker panel can be very effective in detecting these types of cells and hence, the early detection of breast cancer.