Expression of Serum IL-22, IL-23, and TLR9 as Tumor Markers in Untreated Breast Cancer Patients

Breast cancer (BC) is the most common cancer among women and is the most important cause of death among them. Breast cancer is a common malignancy, accounting for one-third of women cancers in Iraq. To the best of our knowledge, little literature information is available on the participation of Interleukin-22 (IL-22), interleukin-23 (IL-23), and Toll-like receptor 9 (TLR9) in BC patients. Thus, the evaluation of serum IL-22, IL-23, and TLR9 level changes can add new information on their roles in breast cancer development and progression. The present study aimed to evaluate the clinical usefulness of IL-22, IL-23, and TLR9 as tumor markers in BC.Levels of circulating interleukin-22, IL-23, and TLR9 were estimated by the enzyme-linked immunoassay method. The serum level of IL-22 was highly significantly elevated in patients compared to the benign and healthy control groups (317.53 ± 14.33 vs. 68.73 ± 12.38 and 62.67 ± 19.11 pg/mL, p ≤ 0.05), but the difference between the benign tumor and healthy control groups means was not significant. Also, these results indicated that the mean level of IL-23 was higher significantly in breast cancer patients in comparison with the benign and healthy controls (887.89 ± 199.04 vs. 146.86 ± 84.26 and 72.26 ± 12.76 pg/mL, p ≤ 0.05). So, no significant difference was revealed between a benign tumor and healthy control groups (146.86 ± 84.26 and 72.26 ± 12.76 pg/mL, p andgt; 0.05). Finally, a serum level of TLR9 was significantly elevated in breast cancer patients in comparison with the control groups (16.89 ± 0.75 vs. 9.97 ± 1.21 ng/mL, 9.06 ± 0.21 ng/mL, p less than 0.05). On estimating IL-22, IL-23, and TLR9, the results showed the concentrations of IL-22, IL-23, and TLR9 in the sera of breast cancer were significantly elevated as compared to those in the control groups. Expression of IL-22, IL-23, and TLR9 could be used as a diagnostic tumor biomarker.