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    2019-09-23

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    data, as well as medical records. The clinical details and demographic characteristics of both patients with BC and benign tumors are summarized in Table 1. The patients with BC and benign tumors were age-matched with control subjects. Of 50 patients with BC, 6 (12%) patients were grade I, 31 (62%) were grade II, 11 (22%) were grade III, and 2 (4%) were grade IV (Table 1). According to immu-nohistochemistry data, there were 35 (70%) patients who were Gilteritinib receptor-positive (ERþ), 28 (56%) patients who were pro-gesterone receptor-positive (PRþ), and 14 (28%) patients who were human epidermal growth factor receptor 2-positive (HER2þ) (Table 1). Of 50 patients with benign breast masses, 39 were diag-nosed as fibroadenoma, whereas 11 patients were diagnosed as other  Essam Eldin Mohamed Nour Eldin et al
    Figure 4 Serum Levels of 8-OHdG, CA15-3, and CEA in Patients With Breast Cancer With Different Histopathology Observations. A, ER-positive, B, PR-positive, and C, HER2/neu-positive. *P < .05
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    Abbreviations: CA15-3 ¼ cancer antigen 15-3; CEA ¼ carcinoembryonic antigen; ER ¼ es-trogen receptor; HER2 ¼ human epidermal growth factor Receptor 2; 8-OHdG ¼ 8-hydroxy-2’-deoxyguanosine; PR ¼ progesterone receptor.
    types, including granulomatous mastitis, papilloma, fibroglandular tissue, ductal ectasia, and others (Table 1).
    The serum level of 8-OHdG in BC was highly significantly increased in patients with BC than in patients with benign lesions, with mean values of 55.21 ng/dL and 30.21 ng/dL, respectively (P < .001) (Table 2 and Figure 1). In comparison with normal healthy controls (9.08 ng/dL), the serum levels of 8-OHdG in both the BC and benign groups were signi ficantly higher (P < .001).
    8-OHdG as Biomarker for Breast Cncer
    Figure 5 Serum Levels of 8-OHdG, CA15-3, and CEA in Patients With BC With and Without Family History of BC (A), With Different BC Types (Invasive/Infiltrating Ductal 
    Figure 6 Correlation Between the Serum Levels of 8-OHdG, CA15-3, and CEA
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    Serum Levels of 8-OHdG Increased in Early Invasive BC
    Changes of the Levels of 8-OHdG in Patients With BC According to Clinical Presentations
    The serum levels of 8-OHdG, CA15-3, and CEA in the patients with BC with different clinical presentations, mass, pain, and discharge, are presented in Figure 3. The levels of 8-OHdG
    Figure 7 The ROC Curve of Serum Levels of 8-OHdG of Studied Subjects. The ROC Curve is species packing a Plot of the Sensitivity (True Positive Rate) at Y-axis Against the 1-Specificity (False Positive Rate) at X-axis for the Different Possible Cut-points of 8-OHdG Diagnostic Test. When the Blue Curve is Closer to the Left-hand Border and Then the top Border of the ROC Space, Then the Test is More Accurate. The Area Under the Curve is 0.86, Indicating Good Accuracy of the 8-OHdG Test
    Abbreviations: 8-OHdG ¼ 8-hydroxy-2’-deoxyguanosine; ROC ¼ receiver operating Characteristic.
    and CA15-3 were significantly lower in patients with BC with pain (P < .01) and discharge (P < .001). However, in patients with BC with mass, significant increased levels of 8-OHdG and CA15-3 (P < .001) were detected. There was a nonsignificant difference in the levels of CEA among the different clinical observations for patients with BC.
    Association Between Predictive Immunohistochemistry (IHC) and 8-OHdG
    Serum levels of 8-OHdG, CA15-3, and CEA in the patients with BC with different histopathology observations, including ERþ, PRþ, and HER2þ are illustrated in Figure 4.
    Relation of 8-OHdG and Family History of BC and Metastasis