Comparative Study of CA 15-3, CA 125, Free Radical Levels, Complete Blood Count, and Glycated Hemoglobin (HbA1c) in Breast Cancer Patients Versus Healthy Women in Eastern Libya

Abstract

Breast cancer is a major health burden, and the identification of reliable biochemical and tumor-related biomarkers may improve disease detection and characterization. This study evaluated serum CA 15-3, CA 125, malondialdehyde (MDA), hematological parameters, and glycated hemoglobin (HbA1c) in breast cancer patients compared with healthy controls, with additional assessment of biomarker correlations and diagnostic performance. Sixty breast cancer patients and 60 healthy controls were evaluated. Demographic characteristics, serum tumor markers, MDA, complete blood count parameters, HbA1c, and fasting glucose were determined. Pearson correlation analysis was performed to investigate associations among biomarkers, while receiver operating characteristic (ROC) curve analysis was used to assess their diagnostic accuracy individually and in combination. Breast cancer patients showed significantly higher serum CA 15-3 (58.4 ± 32.7 vs. 12.8 ± 5.3 U/mL) and CA 125 (42.6 ± 28.4 vs. 14.2 ± 6.1 U/mL) concentrations than controls (p<0.001). MDA levels were also markedly elevated in patients (8.94 ± 3.12 vs. 3.18 ± 1.05 nmol/mL, p<0.001), with significantly higher concentrations in stage III–IV disease than stage I–II disease. Significant hematological alterations included reduced hemoglobin, RBC, and hematocrit and increased WBC and platelet counts (p<0.001). HbA1c and fasting glucose were significantly higher in breast cancer patients than controls (6.42 ± 1.28% vs. 5.28 ± 0.62% and 108.4 ± 24.6 vs. 89.2 ± 12.8 mg/dL, respectively; p<0.001). CA 15-3 was strongly correlated with CA 125 (r=0.682, p<0.001) and MDA (r=0.548, p<0.001), while MDA was negatively correlated with hemoglobin (r=-0.436, p<0.01). ROC analysis demonstrated good diagnostic performance for CA 15-3 (AUC=0.892), MDA (AUC=0.864), and CA 125 (AUC=0.798). The combined CA 15-3 + MDA panel achieved an AUC of 0.934, whereas the four-biomarker panel (CA 15-3 + CA 125 + MDA + HbA1c) demonstrated the highest diagnostic accuracy (AUC=0.956), with 91.7% sensitivity and 93.3% specificity. Breast cancer was associated with increased tumor marker concentrations, oxidative stress, hematological disturbances, and altered glycemic status. The strong associations among CA 15-3, CA 125, MDA, and HbA1c, together with the superior diagnostic performance of the combined biomarker panel, suggest that a multimarker approach may provide greater diagnostic discrimination than individual biomarkers alone.