SERUM FERRITIN, LDH, AND CRP AS POTENTIAL PROGNOSTIC BIOMARKERS IN BREAST CANCER: ASSOCIATION WITH TUMOR GRADE, STAGE, AND RECEPTOR STATUS

Abstract

Inflammatory biomarkers such as serum ferritin, lactate dehydrogenase (LDH), and C-reactive protein (CRP) have been implicated in cancer progression and prognosis. This study aimed to evaluate their association with clinicopathological characteristics in breast cancer patients from Yemen. A cross-sectional analysis of 150 breast cancer patients (60 newly diagnosed, 90 managed) was conducted. Serum levels of ferritin, LDH, and CRP were measured and correlated with tumor size, grade, lymph node status, hormone receptor status, and human epidermal growth factor receptor 2 (HER2) expression. Serum ferritin, LDH, and CRP levels were significantly elevated in patients with higher tumor grade (Grade III), advanced tumor stage (T3/T4), lymph node involvement (N2/N3), and metastatic disease (p<0.05). Ferritin levels were higher in HER2-positive and progesterone receptor-positive tumors. CRP was elevated in estrogen receptor-negative and progesterone receptor-negative subgroups in managed cases. All three markers showed a stepwise increase with advancing tumor burden. Managed patients had significantly lower levels of all markers compared to newly diagnosed patients, indicating treatment response. Serum ferritin, LDH, and CRP are significantly associated with aggressive tumor features in breast cancer. These inexpensive and readily available biomarkers may serve as useful prognostic tools, particularly in resource-limited settings like Yemen, to stratify risk and monitor treatment response.