Clinical Significance of Apoptosis Marker Caspase-3, Tumor Marker CEA, and Electrolyte Imbalance in Breast Cancer Patients

Ahmed A. Al Shammari (1), Wasan Nazhan Hussein (2)
(1) Department of Chemistry, College of Education for Pure Sciences, University of Tikrit, Tikrit, Salah al-Din, Iraq, Iraq,
(2) Department of Chemistry, College of Education for Pure Sciences, University of Tikrit, Tikrit, Salah al-Din, Iraq, Iraq

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Vol. 13 No. 3 (2026): In-Press, Volume 13, Issue 3, August 2026
Keywords:
    breast cancer, caspase 3, carcinoembryonic antigen, serum electrolytes, diagnostic biomarkers
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Abstract

Background: Reliable biomarkers are essential for the early diagnosis and monitoring of breast cancer. This study evaluates serum levels of caspase-3, carcinoembryonic antigen (CEA), and electrolytes in a cohort of healthy individuals and breast cancer patients before and after treatment.


Methods: Ninety female participants were divided into three groups: a control group (n=30), a newly diagnosed group (Group 1, n=20), and a post-treatment group (Group 2, n=40). Serum levels of caspase-3, carcinoembryonic antigen (CEA), and electrolytes (zinc, calcium, sodium, and potassium) were measured. Data were analyzed using analysis of variance (ANOVA) and receiver operating characteristic (ROC) curve analysis.


Results: Caspase-3 levels were lowest in Group 1 (G1) and partially returned toward normal levels in Group 2 (G2). Carcinoembryonic antigen (CEA) levels were higher in Group 2 (G2) compared to Group 1 (G1). Electrolyte levels, particularly calcium (Ca²⁺) and potassium (K⁺), were decreased in Group 1 (G1) and partially returned toward normal levels in Group 2 (G2). ROC curve analysis indicated a moderate diagnostic value for CEA (area under the curve [AUC] = 0.7537).


Conclusion: Serum levels of caspase-3, carcinoembryonic antigen, and electrolytes may help distinguish breast cancer patients from healthy individuals and monitor treatment response.

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References

Harris, J.R.; Lippman, M.E.; Morrow, M.; Osborne, C.K. Diseases of the Breast, 5e; Lippincott Williams & Wilkins, 2014; ISBN 978-1-4511-8627-7.

McIlwain, D.R.; Berger, T.; Mak, T.W. Caspase Functions in Cell Death and Disease. Cold Spring Harb. Perspect. Biol. 2015, 7, doi:10.1101/cshperspect.a026716.

Sturgeon, C.M.; Duffy, M.J.; Stenman, U.H.; Lilja, H.; Brünner, N.; Chan, D.W.; Babaian, R.; Bast, R.C.; Dowell, B.; Esteva, F.J.; et al. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers. Clin. Chem. 2008, 54, doi:10.1373/clinchem.2008.105601.

Wagle, D.B.D.; Deshmukh, D.A.V.; Mangam, D.S.N.; Gangane, D.N.M. Can Caspase-3 Act as a Potential Prognostic Biomarker in Breast Cancer? - A Retrospective Pilot Study in Central India. Int. J. Clin. Diagnostic Pathol. 2023, 6, 76–83, doi:10.33545/pathol.2023.v6.i2b.520.

Duque, G.; Manterola, C.; Otzen, T.; Arias, C.; Palacios, D.; Mora, M.; Galindo, B.; Holguín, J.P.; Albarracín, L. Cancer Biomarkers in Liquid Biopsy for Early Detection of Breast Cancer: A Systematic Review. Clin. Med. Insights Oncol. 2022, 16, doi:10.1177/11795549221134831.

Rosner, M.H.; Dalkin, A.C. Electrolyte Disorders Associated With Cancer. Adv. Chronic Kidney Dis. 2014, 21, 7–17, doi:10.1053/j.ackd.2013.05.005.

Crowther, J. The ELISA Guidebook Series Editor; 2009; Vol. 516; ISBN 9781603272537.

Tietz N.W. Tietz NW. Clinical Guide to Laboratory Tests. 4th Ed. Saunders; ALAN H.B., Ed.; Publishing Director: Andrew Allen Executive Editor: Loren Wilson Developmental Editor: Ellen Wurm Publishing Services Manager: Pat Joiner Project Manager: David Stein Senior Designer: Andrea Lutes, 2006; ISBN 9780721679754.

Elmore, S. Apoptosis: A Review of Programmed Cell Death. Toxicol. Pathol. 2007, 35, 495–516, doi:10.1080/01926230701320337.

Hanahan, D.; Weinberg, R.A. Hallmarks of Cancer: The next Generation. Cell 2011, 144, 646–674, doi:10.1016/j.cell.2011.02.013.

Duffy, M.J. Serum Tumor Markers in Breast Cancer: Are They of Clinical Value? Clin. Chem. 2006, 52, 345–351, doi:10.1373/clinchem.2005.059832.

Blaustein, M.P.; Lederer, W.J.; Annunziato, L. Sodium / Calcium Exchange : Its Physiological Implications. Society 2008, 79, 763–854.

Prasad, A.S. Zinc in Human Health: Effect of Zinc on Immune Cells. Mol. Med. 2008, 14, 353–357, doi:10.2119/2008-00033.Prasad.

Orrenius, S.; Zhivotovsky, B.; Nicotera, P. Regulation of Cell Death: The Calcium-Apoptosis Link. Nat. Rev. Mol. Cell Biol. 2003, 4, 552–565, doi:10.1038/nrm1150.

Zweig, M.H.; Campbell, G. Receiver-Operating Characteristic (ROC) Plots: A Fundamental Evaluation Tool in Clinical Medicine. Clin. Chem. 1993, 39, 561–577, doi:10.1093/clinchem/39.4.561.

Gogtay, N.J.; Thatte, U.M. Statistical Evaluation of Diagnostic Tests – Part 2 [Pre-Test and Post-Test Probability and Odds, Likelihood Ratios, Receiver Operating Characteristic Curve, Youden’s Index and Diagnostic Test Biases]. J. Assoc. Physicians India 2017, 65, 86–91.

Vidak, E.; Vizovišek, M.; Kavčič, N.; Biasizzo, M.; Fonović, M.; Turk, B. Apoptotic Caspases-3 and -7 Cleave Extracellular Domains of Membrane-Bound Proteins from MDA-MB-231 Breast Cancer Cells. Int. J. Mol. Sci. 2025, 26, doi:10.3390/ijms26083466.

Nicholson, D.W.; Thornberry, N.A. Caspases: Killer Proteases. Trends Biochem. Sci. 1997, 22, 299–306, doi:10.1016/S0968-0004(97)01085-2.

Pistritto, G.; Trisciuoglio, D.; Ceci, C.; Alessia Garufi; D’Orazi, G. Apoptosis as Anticancer Mechanism: Function and Dysfunction of Its Modulators and Targeted Therapeutic Strategies. Aging (Albany. NY). 2016, 8, 603–619, doi:10.18632/aging.100934.

Wong, R.S.Y. Apoptosis in Cancer: From Pathogenesis to Treatment. J. Exp. Clin. Cancer Res. 2011, 30, 1–14, doi:10.1186/1756-9966-30-87.

Park, B.W.; Oh, J.W.; Kim, J.H.; Park, S.H.; Kim, K.S.; Kim, J.H.; Lee, K.S. Preoperative CA 15-3 and CEA Serum Levels as Predictor for Breast Cancer Outcomes. Ann. Oncol. 2008, 19, 675–681, doi:10.1093/annonc/mdm538.

Ho, E. Zinc Deficiency, DNA Damage and Cancer Risk. J. Nutr. Biochem. 2004, 15, 572–578, doi:10.1016/j.jnutbio.2004.07.005.

Prasad, A.S. Discovery of Human Zinc Deficiency: Its Impact on Human Health and Disease. Adv. Nutr. 2013, 4, 176–190, doi:10.3945/an.112.003210.

Valko, M.; Rhodes, C.J.; Moncol, J.; Izakovic, M.; Mazur, M. Free Radicals, Metals and Antioxidants in Oxidative Stress-Induced Cancer. Chem. Biol. Interact. 2006, 160, 1–40, doi:10.1016/j.cbi.2005.12.009.

Authors

Ahmed A. Al Shammari
Department of Chemistry, College of Education for Pure Sciences, University of Tikrit, Tikrit, Salah al-Din, Iraq
https://orcid.org/0000-0002-6703-5430
Ahmedchemistry12@gmail.com (Primary Contact)
Wasan Nazhan Hussein
Department of Chemistry, College of Education for Pure Sciences, University of Tikrit, Tikrit, Salah al-Din, Iraq
https://orcid.org/0009-0005-4915-5438
1.
Al Shammari AA, Hussein WN. Clinical Significance of Apoptosis Marker Caspase-3, Tumor Marker CEA, and Electrolyte Imbalance in Breast Cancer Patients. Arch Breast Cancer [Internet]. [cited 2026 Apr. 30];13(3). Available from: https://www.archbreastcancer.com/index.php/abc/article/view/1288
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