| Objective: ADM (adrenomedullin) is a new angiogenesis peptide that extracted from phaochromocytoma. Recently, adrenomedullin has been proved that it is overexpressed in tumor, such as breast cancer. We study the contents of ADM in serum of breast cancers by ELISA ways, and observe the difference between pre-surgery and after-surgery. Then compare them with health control. At the same time, we detect the expression of VEGF, ER and PR in breast cancer tumors by immunity histochemistry ways. We try to find a new way to treat ADM as a new tumor marker by studying their relation. By this way we can monitor the development and metastasis of breast cancer.Methods: We choose 36 patients that were operated in NO.4 hospital of hebei medical university during February of 2005 to October of 2005 (including 22 infitrating ductal carcinomas, 9 infiltrating lobular carcinomas, 2 carcinoma medullare, 1 mucinous adenocarcinoma, 1 poorly differentiated adenocarcinoma and 1 not typical hyperplasia canceration). We measure the expression of ADM in serum of these patients when they are pre-surgery and after- surgery. At the same time, we also choose 15 health controllers, analysis the data that we had detected. We detect the expression of VEGF, ER and PR in breast cancer tumors by immunity histochemistry ways,draw a conclusion and analysis them by SPSS 13.0.Results: 1 The expression of ADM in serum of breast cancers is 6.142±11.135IU/ml, while the health control's is 1.331±1.722IU/ml. The expression of ADM in serum of breast cancers is more than that of health controllers, but it has no significant difference (P=0.134, P>0.05).2 The expression of ADM in serum of pre-surgery breast cancers is 6.142±11.135IU/ml, while the after-surgery's is 1.320±2.584IU/ml. The expression of ADM in serum of pre-surgery breast cancers is more than that of after-surgery breast cancers, it has significant difference (P=0.009, P<0.05). 3 When the size of tumor less than or equal to 2 centimeter (T1), the expression of ADM in serum is 0.667±0.526IU/ml. When the size of tumor less than or equal to 5 centimeter, but more than 2 centimeter (T2), the expression of ADM in serum is 2.371±3.629IU/ml. When the size of tumor is more than 5 centimeter (T3), the expression of ADM in serum is 15.950±16.062IU/ml. At the same time, We can find the correlation between tumor size and the expression of adrenomedullin in serum (P=0.000, P < 0.05). With the increment of the tumor size, the expression of ADM will increase. It has significant difference (P=0.000, P<0.05). When the size of tumor is more than 2 centimeters, the expression of ADM in serum is 7.544±12.024IU/ml, compare it with the health control, we can find there exist significant difference (P=0.028, P<0.05). At equal pace, we compare the expression of the tumor size more than 5 centimeter with health control; we also can find there existing significant difference (P=0.001, P<0.05).4 The expression of ADM in serum of the patients whose axillary nodes metastasis are negative is 5.303±7.154IU/ml, while the positived is 6.740±13.426 IU/ml higher than the before. But it has no significant difference (P>0.05).When the number of axillary node metastasis more than 4, the expression of ADM is more than that of less than 4, it has significant difference (P=0.003, P<0.05).5 The expression of ADM of third stage patients is 18.231±17.635IU/ml, the second stage patients is 2.868±5.332IU/ml, while the first stage patients is 1.851±2.700 IU/ml. With the increment of the stage, the expressions of ADM increase. It has significant difference and correlation (P=0.001, P<0.05). We can find the correlation between TNM stage and the expression of adrenomedullin in serum. With the development of the cancer, the expression of ADM will rise. It has significant difference (P=0.001, P<0.05).6 The expression of ADM in breast cancer was associated with histological grading (P=0.020). With the histological grading increasing, the expression of ADM in serum is 2.765±4.715IU/ml,3.603±6.000IU/ml and 15.526±18.119IU/ml. There was a significant relationship between the expression of ADM and the grade in breast cancer. The expression of ADM in grading III was higher than those in grading II (P =0.043) and III (P =0.010). No significance was found between grading I and II (P =0.075).7 No matter infiltrating ductal carcinoma, infiltrating lobular carcinoma or others pathology how differently, the expression of ADM in serum has no difference (P=0.877, P>0.05). The expression of ADM in serum is 3.471±7.124IU/ml, 7.611±13.114IU/ml and 4.480±7.001 IU/ml one by one. 8 When the patients'age less than or equal to 40 years, the expression of ADM in serum is 4.480±7.000IU/ml. When the patients'age are less than 60 years and more than 40 years, the expression of ADM in serum is 3.850±5.351IU/ml. When the patients'ages are more than 60 years, the expression of ADM in serum is 7.901±16.282IU/ml. It has no significant difference (P=0.281, P>0.05).9 When the patient is premenopausal and postmenopausal, the expression of ADM in serum is 10.051±16.382IU/ml and 10.592±9.163IU/ml. It has no significant difference of two teams, ( P=0.277, P>0.05).10 When the expression of VEGF is negative, the expression of ADM in serum is 0.754±0.828IU/ml. When the expression of VEGF is positive, the expression of ADM in serum is 8.214±12.540IU/ml. In summary, with the different expression of VEGF, the expression of ADM is different, it has significant difference (P=0.012, P<0.05). 11 When the expression of ER is negative, the expression of ADM in serum is 9.477±16.763IU/ml. When the expression of ER is positive, the expression of ADM in serum is 4.474±6.751IU/ml. With the different expression of ER, the expression of ADM is different, it has no significant difference (P=0.240, P>0.05). When the expression of PR is negative, the expression of ADM in serum is 9.103±15.636IU/ml. When the expression of PR is positive, the expression of ADM in serum is 4.026±5.879IU/ml. with the different expression of PR, the expression of ADM is different, it has no significant difference (P=0.304, P>0.05).Conclusions: 1 ADM is overexpression in serum of breast cancers patients. When the surgery is finished, the expression of ADM in serum decreased.2 With the increment of tumor size, the expression of ADM rise. When the tumor size is more than two centimeter, the expression of ADM in serum is higher than that of health control and that of the tumor size less than or equal to 2 centimeter.3 It has no significant difference between the node metastasis negative and positive. The patients whose axillary node metastasis more than or equal to 4, the expression of ADM is higher than that of axillary node metastasis less than 4 and health control.4 The more serious of cancer, the higher expression of ADM in serum. 5 The expression of ADM in breast cancer was associated with histological grading. The expression in grading III was higher than those in grading I and III, which suggested the stronger expression of ADM, the higher malignant of the breast cancer.6 The expression of ADM has no correlation with the expression of ER, PR, age, and pathology, menopausal status.7 With the intensification of the expression of VEGF, the expressions of ADM increase.
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