Assessment of Hypoxemia Status By Measuring Serum Level of Hypoxia Inducible Factor 1 Alpha in Relation To Tumor Suppression Protein P53, Estradiol and Tumor Proliferation Markers of Breast Cancer in Thi-Qar Province/Iraq

Hypoxemia means low levels of oxygen in the blood and it alters cancer cell metabolism and causes multiple intracellular signaling pathways. investigate hypoxia status by measuring the concentration of hif-1α as a prognostic factor of hypoxia and its relation to tumor suppressor protein p53, estradiol, tumor grade, tumor size, and lymph node metastases of adult female with breast cancer. this study is a case control study which includes sixty- five adult female patients with breast mass. out of 65 patients, a 44 (68%) were with fibroadenoma in the age range of 18-42 (32.55±6.40) and the other 21 (32%) cases with breast cancer type invasive ductal carcinoma (idc) aged 32-80 (56± 14.4). most idc cases were in grade iii and sizes t2 and t3. the other 50 healthy females, as a control group were in mean age of 44.56±16.85. preoperative blood samples were collected for biochemical analysis by the elisa method. a significant elevation in serum hif-1α, p53 and e2 (p<0.001) in idc cases as compared to fibroadenoma and the control group, there was a positive relation between hif-1α, p53, and e2. hif-1 α, p53, and e2 were significantly elevated in the patients with grade iii and tumor stage t3 than grade ii and stages t2 and t1. a significant elevation was found in the subgroup of positive lnm for all preoperative serum levels of parameters compared with the negative lnm patients group. hif-1α, p53, and e2 were useful markers of invasion depth of tumor or lnm in breast cancer staging and the interactions between hif-1α, p53, and e2 signaling pathways may be of major clinical significance in cancer therapies through targeting the lowering of severity of hypoxia and angiogenesis.