New biomarker in the early diagnosis of breast cancer: adiponectin, asprosin, adropin, and resistin

BACKGROUND: Early diagnosis of breast cancer remains difficult despite advances in imaging because false-positive and false-negative findings still occur. Circulating biomarkers reflecting metabolic and inflammatory changes may provide complementary information. Adiponectin, adropin, asprosin, and resistin have been suggested as candidates, yet their comparative diagnostic performance in breast cancer has not been adequately defined. METHODS: This study included ninety women aged 18-60 years allocated to malignant breast cancer, benign breast disease, and healthy control groups (n = 30 each). All malignant cases were invasive ductal carcinoma. Serum adiponectin, adropin, asprosin, and resistin concentrations were measured using enzyme-linked immunosorbent assay. Group comparisons used parametric or non-parametric tests as appropriate. Diagnostic accuracy was evaluated by receiver operating characteristic analysis, optimal cut-off values by the Youden index. When appropriate, post hoc pairwise comparisons were performed following overall group comparisons to identify between-group differences. RESULTS: Adiponectin levels were significantly lower, whereas adropin, asprosin, and resistin levels were significantly higher in malignant cases than in benign disease and controls (all p < 0.001). Receiver operating characteristic analysis showed good to excellent discrimination for adropin (AUC 0.893), asprosin (AUC 0.906), and resistin (AUC 0.908), while adiponectin demonstrated moderate accuracy (AUC 0.786). Adropin, asprosin, and resistin correlated strongly with each other and showed moderate relationships with tumor size and stage; adiponectin displayed weaker correlations. CONCLUSION: Adropin, asprosin, and resistin show promising diagnostic value for early breast cancer and outperform adiponectin. These biomarkers may complement imaging in clinical evaluation, although larger prospective studies are needed to confirm clinical applicability and to establish standardized thresholds for routine clinical practice across diverse patient populations.