EBV, CMV, HSV and HPV role in breast cancer development molecular and immunological study in Iraq

Breast cancer is a heterogeneous, challenging disease. It is the most frequent cancer found in women in the Middle East. The objectıve of this study is to identify women who are at high risk for breast cancer, and whether there is a relationship with viral infections. This helps provide insight into some breast cancer screening tests, and make some suggestions about such tests. This study included 79 breast cancer wonen as patients group and 79 healthy women as control group. All patient and control serum samples were subjected to the determination of viruses' immunoglobulin G seropositivity and CA15-3. Tissue samples were collected as FFPE blocks.79 sample tested to evaluate the expression of estrogen, progestron and human epidermal growth factor 2. 40 tissue samples from HSV-2 seropositive patients were tested to detect the HSV-2 viral load by Real-Time PCR. Breast cancer in our study was predominant in the age group of 41-50 years. Both ER and PR (positivity rate and cell numbers) were with significant predictive values with grade I and grade III breast cancer, while HER-2 was with significant predictive value in breast cancer with grade III and grade IV. CMV IgG as well as, EBV VCA IgG seroprevalence was significantly higher in patients as compared to control. HPV-18 and HPV-16 antibody seropositivity was higher in patients than in controls. Odds ratio (OR) indicated a significant association between breast cancer and CMV IgG, HSV-2 IgG, and EBV VCA IgG seropositivity. Additionally, HSV-2 IgG seroprevalence was significantly higher in patients than in controls. HSV-2 viral genetic material was detected in 17.5% of tested breast cancer tissue samples.CA15-3 mean serum level was higher in breast cancer patients as compared to control group. ER and PR-positive breast cancer were found in 64.6% of cases, with significant differences between grades of breast cancer. While HER2-positivivity rate was 26.6%. The mean CA15-3 values were significantly higher in ER, PR, and HER2-positive breast cancer. About 2/3 of breast cancer cases are ER and PR positive and this may influence the therapeutic approach of breast cancer cases. Fortunately, 1/4 of cases are HER2 positive as they are with poor prognosis.