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Abstract

Background & objective: Breast cancer is one of the leading and most aggressive cancers in women worldwide. Pancreatic dysfunction is common among cancer patients and is associated with chronic inflammation and metastatic breast cancer. The inflammation markers, Metabolic Alkaline Phosphate (ALP), Interleukin-6 (IL-6), and C-reactive Protein (CRP) are often associated with metabolic disruptions. Some genetic polymorphisms, like the SNP of the TCF7L2 gene, have been associated with metabolic disorders and pancreatic insufficiency. We assessed the diagnostic correlates of biomarkers ALP, IL-6, and CRP and pancreatic dysfunction in breast cancer patients and evaluated the relationship of polymorphisms of the TCF7L2 gene with pancreatic dysfunction. 
Methods: The biomarkers were detected using ELISA, and the levels of ALP, IL-6, and CRP were compared between breast cancer patients and healthy individuals. The TCF7L2 Gene polymorphism (rs12255372) was performed by T-ARMS PCR and agarose gel electrophoresis. Diagnostic assessment was conducted by ROC curve and chi-square statistical analysis of the polymorphisms TCF7L2 and markers of pancreatic dysfunction.
Results: The results suggest that ALP as a single marker lacks sufficient sensitivity for diagnosing pancreatic dysfunction in breast cancer patients (AUROC=0.55). CRP showed moderate diagnostic potential with an AUC of 0.60, but breast cancer patients paradoxically had lower CRP compared to healthy controls. IL-6 performed poorly as well, since no differences were found between patients and controls. The analysis of the TCF7L2 gene polymorphism showed that there was an increased prevalence of the GG genotype among breast cancer patients, which may indicate pancreatic dysfunction.
Conclusion: ALP, IL-6, and CRP, as individual biomarkers, did not prove useful for the diagnosis of pancreatic dysfunction in breast cancer patients, but an enhancement in diagnostic accuracy may be achievable with the use of other adjunct markers. The particular polymorphism of the TCF7L2 gene, with focus on the GG genotype, may be another factor contributing to pancreatic dysfunction in breast cancer patients. More research is necessary to understand the relations between these markers and other genetic factors to formulate better and targeted interventions for pancreatic dysfunction arising from breast cancer.
Abbreviations: ALP: Metabolic Alkaline Phosphate, IL-6: Interleukin-6, CRP: C-reactive Protein
Keywords: Inflammatory Biomarkers; Metabolic Disorders; Type 2 Diabetes Mellitus; Metabolic Alterations; Cancer
Citation: AL-jdooa DI, Al-Ziaydi AG. The influence of gene polymorphisms and biomarkers (ALP, IL-6 and CRP) on pancreatic dysfunction in breast cancer patients. Anaesth. pain intensive care 2025;29(7):702-711. DOI: 10.35975/apic.v29i7.2974
Received: April 25, 2025; Revised: May 27, 2025; Accepted: June 10, 2025