Sains Malaysiana 50(11)(2021): 3321-3332

http://doi.org/10.17576/jsm-2021-5011-16

Association of Serum Vitamin D Level and Vitamin D Receptor Expression among Newly Diagnosed Breast Cancer

(Hubungan antara Tahap Serum Vitamin D dan Pengekspresan Reseptor Vitamin D dalam Kalangan Pesakit Kanser Payudara Baharu Didiagnos)

HANI AJRINA ZULKEFLEE^1,5, TUAN SALWANI TUAN ISMAIL^1,4*, TENGKU AHMAD DAMITRI AL-ASTANI TENGKU DIN^1,4,6, MAYA MAZUWIN YAHYA^2,4,6 & WAN FAIZIAH WAN ABDUL RAHMAN^3,4

¹Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

²Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

³Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

⁴Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

⁵Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Bandar Baru Nilai, 71800 Nilai, Negeri Sembilan, Malaysia

⁶Breast Cancer Awareness and Research Unit (BestaRi), Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

Received: 11 August 2020/Accepted: 15 March 2021

ABSTRACT

There is a mushrooming interest in the anti-carcinogenic property of vitamin D. However, many researches reported a conflicting result in the association of vitamin D levels to certain types of cancer. This study was designed to assess the association between vitamin D and vitamin D receptor (VDR) expression with breast cancer. This case-control study, carried out at Hospital Universiti Sains Malaysia, Kelantan, involved 69 newly diagnosed breast cancer patients and 73 healthy volunteers. Serum 25(OH)D was taken and compared between 2 groups. VDR expression in patients’ breast tissue samples was determined by immunohistochemical staining method using anti-VDR antibody. 85.5% of breast cancer patients and 97.3% of healthy control were vitamin D insufficient with a mean (SD) of 13.36 (6.96) ng/mL and 13.05 (3.71) ng/mL, respectively, and the difference was not statistically significant. VDR expression showed cytoplasmic positivity in 75.4% of breast cancer tissue, followed by both cytoplasmic and nuclear positivity in 21.5% and complete absence in 3%. There was no significant association between VDR expression and hormone receptor status. In conclusion, there was a high prevalence of vitamin D deficiency among breast cancer and healthy volunteers in our study. There was no significant association between breast cancer and vitamin D. The VDR expression in breast cancer cells showed high cytoplasmic localization.

Keywords: Breast cancer; prognosis; risk; vitamin D; vitamin D receptor expression

ABSTRAK

Dewasa ini, kajian mengenai sifat anti-kanser pada vitamin D semakin meluas. Namun demikian, banyak kajian mengenai hubungan antara tahap vitamin D dan jenis-jenis kanser melaporkan keputusan yang berbeza. Oleh itu, kajian ini dijalankan untuk menilai hubungan antara tahap vitamin D dan reseptor vitamin D (VDR) dengan kanser payudara. Kajian kes kawalan ini telah dijalankan di Hospital Universiti Sains Malaysia (HUSM), Kelantan, yang melibatkan 69 pesakit yang baru disahkan menghidapi kanser payudara dan 73 orang sukarelawan yang sihat. Serum 25(OH)D telah diambil dan bacaannya dibandingkan antara 2 kumpulan. Pengekspresan VDR dalam sampel tisu payudara pesakit ditentukan melalui teknik imunohistokimia menggunakan antibodi anti-VDR. 85.5% daripada pesakit kanser payudara dan 97.3% sukarelawan mempunyai kekurangan vitamin D dengan purata (SD) dalam kalangan pesakit adalah 13.36 (6.96) ng/mL dan dalam kalangan sukarelawan adalah 13.05 (3.71) ng/mL. Perbezaan tahap vitamin D dalam kalangan pesakit dan sukarelawan tidak signifikan dari segi statistik. 50.7% daripada tisu kanser payudara merupakan VDR positif. Pengekspresan VDR wujud dalam 75.4% sitoplasma sel kanser payudara, 21.5% pada sitoplasma dan nukleus dan 3% tidak wujud pada sel kanser. Kajian ini tidak menunjukkan sebarang hubungan yang signifikan antara pengekspresan VDR dan status reseptor hormon. Kesimpulannya, kajian ini melaporkan kekurangan vitamin D yang tinggi dalam kalangan pesakit kanser payudara dan sukarelawan. Tiada hubungan yang signifikan antara kanser payudara dan tahap vitamin D. Pengekspresan VDR pada sel kanser payudara menunjukkan penyetempatan sitoplasma yang tinggi.

Kata kunci: Kanser payudara; pengekspresan reseptor vitamin D; prognosis; risiko; vitamin D

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*Corresponding author; email: tusti@usm.my