THE RELATIONSHIP BETWEEN CONCENTRATIONS OF CIRCULATING SOLUBLE E-SELECTIN AND CLINICAL, PATHOLOGICAL, AND BIOLOGICAL FEATURES IN PATIENTS WITH BREAST-CANCER

Increasing evidence suggests that E-selectin contributes to tumor grow th and metastasis. E-selectin may increase tumoral angiogenesis and th e adhesion of tumoral cells to endothelial cells at distant sites. The aim of this study was to assess the relationship between concentratio ns of circulating soluble E-selectin (sE-selectin) and clinical, patho logical, and biological features in patients with breast cancer (BC). Concentrations of sE-selectin were analyzed by an ELISA method in sera from 113 patients with metastatic BC, 30 patients with primary inflam matory BC, 105 patients with primary noninflammatory BC, and 42 health y controls. These concentrations were analyzed in terms of the clinica l and pathological features of the tumors as well as in terms of the c oncentrations of serum inflammatory parameters (erythrocyte sedimentat ion rate, C reactive protein, interleukin 1 beta, and tumor necrosis f actor alpha), the response to chemotherapy or hormone therapy, and the survival duration. Tumoral angiogenesis was also assessed in 68 patie nts with primary noninflammatory BC who had had primary surgery. The m ean concentration of sE-selectin in the metastatic BC group was signif icantly higher than the mean concentration found in the healthy contro l group (33.5 versus 21.8 ng/ml; P < 0.01). In metastatic BC, the mean concentration of sE-selectin was significantly higher in patients wit h liver metastasis than in patients without liver metastasis (55.3 ver sus 26.0 ng/ml; P < 10(-5)). The univariate analysis showed that high concentrations of sE-selectin were associated with reduced overall sur vival (P < 0.05), but this probably reflected the association between high concentrations of sE-selectin and liver metastasis. In patients w ith primary noninflammatory BC, a negative correlation was found betwe en sE-selectin concentrations and the tumoral microvessel count (r = - 0.47; P = 10(-4)). In patients with primary inflammatory or noninflamm atory BC, no correlation was found between concentrations of sE-select in and tumor size, lymph node involvement, response to chemotherapy or hormone therapy, and survival. No correlation was found between the c oncentrations of sE-selectin and serum inflammatory parameters in any of the patient groups. This study suggests that in patients with metas tatic BC, levels of sE-selectin are higher in the presence of Liver me tastasis. In patients with primary BC, high concentrations seem to be associated with reduced tumoral angiogenesis. Although several studies have previously demonstrated that the expression of cell surface E-se lectin enhances the metastatic process, the shedding of sE-selectin in circulation may be considered a mechanism of inhibition of tumor prog ression.