Abstract
BACKGROUND: Breast cancer remains a leading cause of cancer-related mortality, with postoperative recurrence and metastasis being major challenges despite advancements in surgical intervention. Current prognostic tools primarily rely on histopathological staging and tumor biomarkers, which lack dynamic monitoring capabilities for postsurgical outcomes. Emerging evidence highlights the roles of soluble E-cadherin (sEC) and soluble endoglin (s-CD105) in tumor progression: sEC reflects epithelial-mesenchymal transition (EMT) and tumor invasiveness, while s-CD105 correlates with angiogenesis. However, limited studies have jointly evaluated their predictive value in postoperative breast cancer patients. OBJECTIVE: To investigate the clinical utility of serum sEC and s-CD105 as dynamic biomarkers for predicting postoperative recurrence/metastasis in breast cancer patients undergoing modified radical mastectomy, and to establish evidence-based cut-off values for clinical application. METHODS: A retrospective cohort of 80 breast cancer patients (January 2019-December 2022) was stratified into recurrence/metastasis (n=40) and control (n=40) groups based on 3-year follow-up. Serum sEC and s-CD105 levels were quantified postoperatively using ELISA. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess their independent predictive value while controlling for TNM stage, tumor size, and demographic confounders. RESULTS: There were no significant differences in baseline characteristics, including age and BMI, between the two groups (P>0.05). Laboratory indicators also showed no significant differences (P>0.05). However, the recurrence/metastasis group exhibited significantly higher postoperative serum sEC and s-CD105 levels compared to the control group (P<0.05). Univariate analysis revealed that TNM staging and maximum tumor diameter differed significantly between the groups (P<0.05). Multivariate logistic regression analysis identified TNM staging, serum sEC, and s-CD105 levels as independent risk factors for postoperative recurrence and metastasis in breast cancer patients (P<0.05). ROC curve analysis demonstrated that serum sEC and s-CD105 levels have predictive value for postoperative recurrence and metastasis in these patients (P<0.05). CONCLUSION: This study demonstrates for the first time that postoperative serum sEC and s-CD105, measured at defined thresholds, independently predict recurrence/metastasis in breast cancer patients. Their combined assessment enhances prognostic accuracy beyond conventional staging, offering a novel tool for personalized surveillance and intervention strategies.