AUTHOR=Mego Michal , Vlkova Barbora , Minarik Gabriel , Cierna Zuzana , Karaba Marian , Benca Juraj , Sedlackova Tatiana , Cholujova Dana , Gronesova Paulina , Kalavska Katarina , Pindak Daniel , Mardiak Jozef , Celec Peter 

TITLE=Vitamin D and circulating tumor cells in primary breast cancer

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.950451

DOI=10.3389/fonc.2022.950451

ISSN=2234-943X

ABSTRACT=Background: Circulating tumor cells (CTCs) contribute to the metastatic cascade and represent an independent survival predictor in breast cancer (BC) patients. Vitamin D has pleiotropic effects and its low concentrations are associated with breast cancer and metastasis. The aim of this study was to assess plasma vitamin D in primary BC patients in relation to CTCs
Methods: This study included 91 non-metastatic BC patients (stage I-III). Blood samples for the analyses were drawn at the time of surgery. CTCs were assessed using a quantitative RT-PCR assay for expression of epithelial (CK19) or epithelial-mesenchymal transition (EMT) genes (TWIST1, SNAIL1, SLUG, ZEB1). Total 25-OH vitamin D was measured in plasma using ELISA.
Results: CTCs were detected in 30 (33%) patients. Patients with detectable CTCs in peripheral blood had significantly lower vitamin D concentrations in comparison to patients without detectable CTCs (mean ± SD) 8.50 ± 3.89 µg/L for CTCs positive vs. 9.69 ± 3.49 µg/L for CTCs negative patients respectively, P = 0.03). There was no association between plasma vitamin D and other patient/tumor characteristics. Patients with vitamin D above median had a better overall survival (HR = 0.36, 95%CI 0.16 – 0.80, P = 0.017).
Conclusions: Low vitamin D could be a consequence and hence a biomarker of a more invasive disease. Alternatively, vitamin D could be associated with survival because of its role in tumor
dissemination. Whether its supplementation affects the metastatic cascade should be tested in animal experiments and interventional studies.