br Sieuwerts AM Kraan J
 Sieuwerts AM, Kraan J, Bolt J, van der Spoel P, Elstrodt F, Schutte M, et al. Anti-epithelial cell adhesion molecule Z-Guggulsterone and the detection of circulating normal-like breast tumor cells. J Natl Cancer Inst 2009;101(1):61e6.
 Punnoose EA, Atwal S, Liu W, Raja R, Fine BM, Hughes BG, et al. Evaluation of circulating tumor cells and circulating tumor DNA in non-small cell lung cancer: association with clinical endpoints in a phase II clinical trial of pertuzumab and erlotinib. Clin Cancer Res 2012;18(8):2391e401.
 Ng CK, Schultheis AM, Bidard FC, Weigelt B, Reis-Filho JS. Breast cancer genomics from microarrays to massively parallel sequencing: paradigms and new insights. J Natl Cancer Inst 2015; 107(5).
 Lehmann BD, Pietenpol JA. Clinical implications of molecular heterogeneity in triple negative breast cancer. Breast 2015; 24(Suppl 2):S36e40.
 Kumari S, Tewari S, Husain N, Agarwal A, Pandey A, Singhal A, et al. Quantification of circulating free DNA as a diagnostic marker in gall bladder cancer. Pathol Oncol Res 2017;23(1):91e7.
 Massard C, Borget I, Farace F, Aspeslagh S, Le Deley MC, Le Tourneau C, et al. RECIST response and variation of circulating tumour cells in phase 1 trials: a prospective multicentric study. Eur J Cancer 2017;83:185e93.
 Budd GT, Cristofanilli M, Ellis MJ, Stopeck A, Borden E, Miller MC, et al. Circulating tumor cells versus imaging–pre-dicting overall survival in metastatic breast cancer. Clin Cancer Res 2006;12(21):6403e9.
 Cohen SJ, Punt CJ, Iannotti N, Saidman BH, Sabbath KD, Gabrail NY, et al. Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J Clin Oncol 2008; 26(19):3213e21.
 Lee YJ, Yoon KA, Han JY, Kim HT, Yun T, Lee GK, et al. Circulating cell-free DNA in plasma of never smokers with advanced lung adenocarcinoma receiving gefitinib or standard chemotherapy as first-line therapy. Clin Cancer Res 2011;17(15): 5179e87.
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Current Problems in Cancer
journal homepage: www.elsevier.com/locate/cpcancer
Association of elevated levels of C-reactive protein with breast cancer, breast cancer subtypes, and poor outcome
Raman Preet Kaur a, Rubal b, Raja Paramjeet Singh Banipal c, Rajesh Vashistha d, Monisha Dhiman b, Anjana Munshi a,∗ a Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab, India b Department of Biochemistry and Microbial Sciences, Central University of Punjab, Bathinda, Punjab, India
c Guru Gobind Singh Medical College & Hospital, Faridkot, Punjab, India d Max Super-Specialty Hospital, Bathinda, India
Infiltrating ductal carcinoma
Background and Purpose: Inflammation and caner are linked in a bidirectional manner. C-reactive protein (CRP) is an im-portant inflammatory marker. The aim of the study was to test whether the inflammatory marker, CRP at the time of di-agnosis of breast cancer is associated with metastasis, recur-rence, and death in breast cancer patients from Malwa region of Punjab where breast cancer is widely feared.
Material and Methods: Two hundred and forty-two breast cancer patients and 242 age and sex matched controls were included in the study. CRP levels were estimated using fully automated bio analyzer Erba200. Follow up interviews were conducted at an interval of 3, 6, 9, 12, 15, 18, 21, 24, and 27 months to determine the outcome among breast cancer pa-tients.
Results: Elevated levels of CRP were found among the dis-eased in comparison with controls (P < 0.0001). Higher CRP levels associated significantly with poor outcome includ-
Financial assistance provided by Central University of Punjab, Bathinda (CUPB) is acknowledged with thanks. Conflict of interest: The authors declare that conifers have no conflict of interest.
Compliance with Ethical Standards: The blood sample collection of breast cancer patients for the present study was approved by Institutional Ethics Committee (IES) of CUPB.
∗ Correspondence to: Anjana Munshi, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, India.
E-mail address: [email protected] (A. Munshi).
Conclusion: Elevated levels of CRP associated significantly with increased risk of breast cancer and poor outcome. CRP estimation may be a simple and inexpensive tool for the risk assessment and outcome of the disease in Malwa region of Punjab where incidence of breast cancer is reported to be very high.