Evaluation of Serum 25-Hydroxyvitamin D, Ferritin, and CA 15-3 Levels in Women with Breast Cancer: An Iraqi Comparative Study

Marwa Adel  Hussein; Ibrahim Ramzi Hadi; Mais Adnan  Al_Ward; Mithat  Güllü

doi:10.47419/bjbabs.v7i2.440

Authors

Marwa Adel Hussein Higher Institute of Forensic Sciences, Al-Nahrain University, Baghdad, Iraq. https://orcid.org/0009-0002-8278-5413
Ibrahim Ramzi Hadi Higher Institute of Forensic Sciences, Al-Nahrain University, Baghdad, Iraq; Department of Biology, Graduate School of Natural and Applied Sciences, Erciyes University/Kayseri-Turkey
Mais Adnan Al_Ward Higher Institute of Forensic Sciences, Al-Nahrain University, Baghdad, Iraq. https://orcid.org/0009-0000-3267-9925
Mithat Güllü Faculty of Science, Department of Biology, Erciyes University, Kayseri, Türkiye https://orcid.org/0000-0001-7100-9609

DOI:

https://doi.org/10.47419/bjbabs.v7i2.440

Keywords:

Breast Cancer, Vitamin D3, Ferritin, Cancer Marker, CA 15.3

Abstract

Background and objective: The most malignant disease among women in Iraq is breast cancer, rendering the identification of reliable biomarkers a priority for initial detection and disease monitoring. Despite the broad usage of CA 15-3 as a tumor-associated marker, its diagnostic value is limited. Vitamin D deficiency and altered iron metabolism, as reflected in serum ferritin levels, have also been implicated in cancer development. This study aims to examine levels of 25-hydroxyvitamin D [25(OH)D], ferritin, and CA 15-3 in women with breast cancer compared with healthy controls, and to assess their diagnostic performance.
Methods: The study carried out a comparative cross-sectional examination of 50 women suffering from breast cancer and 50 healthy controls of matching age. The 25(OH)D and ferritin levels were identified using electrochemiluminescence immunoassays, while the quantification of CA 15-3 was performed via enzyme-linked immunosorbent assay. Data analysis relied on SPSS version 29.
Results: The patients exhibited notably lower levels of 25(OH)D serum (18.9 ± 2.4 ng/ml) in comparison to the controls (34.6 ± 3.6 ng/ml; P < 0.001). Ferritin levels were higher in patients (45.3 ± 5.3 ng/ml) than controls (31.0 ± 3.9 ng/ml; P < 0.001). CA 15-3 was also markedly elevated in the patients (45.2 ± 2.5 U/ml) in comparison to the controls (17.9 ± 3.7 U/ml; P < 0.001). Correlation analysis within patients showed a moderate positive association between CA 15-3 and 25(OH)D (r = 0.50, 95% CI 0.24–0.69, P < 0.001) and a weaker correlation with ferritin (r = 0.28, 95% CI 0.00–0.53, P = 0.047). Receiver operating characteristic analysis showed good diagnostic discrimination: 25(OH)D (AUC = 0.85, 95% CI 0.77–0.92), ferritin (AUC = 0.83, 95% CI 0.74–0.91), and CA 15-3 (AUC = 0.99, 95% CI 0.97–1.00).
Conclusions: Iraqi women with breast cancer exhibited significantly reduced vitamin D and elevated ferritin alongside increased CA 15-3. While CA 15-3 provided the highest diagnostic accuracy, both vitamin D deficiency and elevated ferritin demonstrated additional discriminative value. A combined biomarker approach may offer a more comprehensive strategy for disease assessment, and greater prospective research is recommended to verify these results.