Abstract
OBJECTIVE: This study aimed to investigate the serum levels and clinical significance of Acyl-CoA synthetase long-chain family member 4 (ACSL4) in patients with early-stage breast cancer, and to evaluate its potential as a diagnostic and prognostic biomarker. METHODS: In this prospective observational study, serum levels of ACSL4, inflammatory factors (CRP, IL-6, and IL-17), and tumor markers (CEA and CA153) were measured using enzyme-linked immunosorbent assay (ELISA) in 138 early-stage breast cancer patients and 115 patients with benign breast lesions. Demographic, clinical, and follow-up data were collected, and statistical analyses were performed to assess the diagnostic and prognostic value of ACSL4. RESULTS: Serum ACSL4 levels were significantly lower in early-stage breast cancer patients compared to those with benign breast lesions (p < 0.01). Serum ACSL4 levels showed diagnostic performance for early-stage breast cancer, with an AUC of 0.774 (95% CI 0.717-0.813), a cut-off value of 21.47 ng/ml, yielding 73.9% sensitivity and 65.2%. Although not statistically significant, trends in survival analysis suggested that lower ACSL4 levels might be associated with poorer outcomes. Multivariate logistic regression identified serum ACSL4 as an independent risk factor for early-stage breast cancer progression (OR 1.407, 95% CI 1.274-1.554; p < 0.001). CONCLUSION: Serum ACSL4 levels were significantly lower in early-stage breast cancer patients and might serve as a useful serum indicator to support diagnosis. These findings suggested the potential clinical relevance of ACSL4 in breast cancer and highlighted the need for further studies to validate its diagnostic and prognostic value.