International Journal of Clinical Medicine, 2013, 4, 405-408
http://dx.doi.org/10.4236/ijcm.2013.49073 Published Online September 2013 (http://www.scirp.org/journal/ijcm) 405
Evaluation of Glutathione, Albumin and Ascorbic Acid
Levels in Breast Cancer Patients
P. Faizal1, B. Satheeshan2, Milind Kumar3, A. K. Adarsh1, R. Shilpa1, P. Roshni1, T. Remya1,
K. T. Augusti1
1Department of Medical Biochemistry, School of Health Sciences, Kannur University, Thalassery, India; 2Department of Surgical
Oncology, Malabar Cancer Centre, Thalassery, India; 3Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, India.
[e-mail], [e-mail], [e-mail],
Received May 22nd, 2013; revised June 26th, 2013; accepted July 5th, 2013
Copyright © 2013 P. Faizal et al. This is an open access article distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Recently, an increase of global incidence has been observed for various types of cancers. Diet, lifestyle and environ-
mental factors have an evident correlation to the development of breast cancer. Breast cancer is one of the leading
causes of cancer related death in women. Several studies also revealed that excessive free radical generation and
decreased antioxidant status had been implicated in cancer. These factors rekindled our interest upon the interaction of
free radicals and antioxidants and hence the present study was undertaken to evaluate the significance of non enzymic
antioxidants: glutathione, albumin and ascorbic acid levels in breast cancer patients. The study population was divided
into 3 groups as follows: Group I control subjects (age group 21 - 60), Group II: breast cancer Patients (age group 21 -
35) and Group III breast cancer patients (age group 36 - 60). Highly statistically significant increases in glutathione,
albumin and ascorbic acid levels were observed in Group I as compared to other groups. No significant differences in
glutathione, albumin and ascorbic acid levels were observed in a group comparison between Group II and Group III.
This relative decline of non enzymic antioxidants in breast cancer patients may be due to an increased generation of
reactive oxygen species or free radicals. The results obtained emphasize the need of more detailed study involving a large
number of newly detected cancers for evaluating the role of these antioxidant parameters in the prevention of cancer.
Keywords: Free Radicals; Antioxidants; Reactive Oxygen Species
1. Introduction
Cancer is a class of diseases or disorders characterized by
uncontrolled division of cells and the ability of these
cells to invade other tissues, either by direct growth into
adjacent tissue through invasion or by implantation into
distant sites by metastasis [1]. Diet, lifestyle and envi-
ronmental factors contribute to the etiology of cancer. It
has been estimated that 35 percent of cancer deaths may
be related to dietary factors. Almost all cancers (80% -
90%) are caused by environmental factors, and of these,
30% - 40% of cancers are directly linked to the diet [2,3].
Oxygen radicals are continuously formed in all living
organisms, with deleterious effects that lead to cell injury
and death. Production of oxidative species occurs under
physiological conditio ns at a controlled rate, but it is dra-
matically increased in conditio ns of oxidative stress. Cell
damage caused by free radicals appears to be a major
contributor in aging and degenerative diseases of aging
such as cancer, cardiovascular disease, cataracts, com-
promised immune system, rheumatoid arthritis and brain
dysfunction [4]. Free radicals have been implicated in the
pathogenesis of at least 50 diseases. Fortunately, free
radical formation is controlled naturally by various bene-
ficial compounds known as antioxidants. Antioxidants
are capable to stabilize, deactivate or scavenge free radi-
cals before they attack cells. Antioxidants play an im-
portant role in maintaining optimal cellular and systemic
health and well-being of the body. Antioxidant action
includes free radical scavenging capacity, inhibition of
lipid peroxidation, metal ion chelating ability and reduc-
ing capacity [5].
Recently, an increase of global incidence has been ob-
served for various types of cancers [6]. Diet, lifestyle and
environmental factors have an evident correlation to the
development of breast cancer. Breast cancer is one of the
leading causes of cancer-related death in women [7].

Evaluation of Glutathione, Albumin and Ascorbic Acid Levels in Breast Cancer Patients 406
Several studies also revealed that excessive free radical
generation and decreased antioxidant status had been
implicated in cancer [8]. These factors rekindled our in-
terest upon the interaction of free radicals and antioxi-
dants and hence the present study was undertaken to
evaluate the significance of non enzymic antioxidants:
glutathione, albumin and ascorbic acid levels in breast
cancer patients.
2. Materials and Methods
Cancer patients registered at the Malabar Cancer Centre,
Thalassery, were chosen as the patient group (age: 21 -
60). A total of 60 breast cancer patients as adjudged from
clinical features, histopathological and biochemical in-
vestigations were selected for the study. As control group
30 normal healthy subjects of the same age group as that
of the cancer patients were taken. Participants suffering
from any diseases that may interfere with the study were
excluded. The work has been carried out at the Malabar
Cancer Centre, Thalassery and Department of Medical
Biochemistry, School of Health Sciences, Kannur Uni-
versity. Ethical committee from both the collaborating
institutions approved the study. An informed consent for
the study was obtained from each participant. The Clinical
proforma was given to each patient to collect data such
as height, weight, diet pattern, pr evious history of illness
etc. Patients suffering from any disease that may interfere
with the study were excluded. A log book was main-
tained for the patients. The study population was divided
into 3 groups as a group I co ntrol subjects (age group 21
- 60), Group II: breast cancer Patients (age group 21 - 35)
and Group III breast cancer patients (age group 36 - 60).
2 ml blood sample was taken for the analysis from each
of the control subjects and the patients. Plasma was
separated and assayed using standard methods. The analy-
sis of Glutathione [9] (DTNB method), Albumin [10]
(BCG method), and Ascorbic acid [11] (2,6-Dichloro-
phenol-indophenol method) were carried out using stan-
dard methods. The statistical analysis was performed by
paired students “t” test using Software Package for So-
cial Sciences (SPSS 18).
3. Results and Discussion
In the present study, significant decreases in the plasma
levels of glutathione, albumin and ascorbic acid were
observed in breast cancer patients undergoing treatment
as compared to control subjects (Tables 1 and 2). This
relative decline of non enzymic antioxidants in breast
cancer patients may be due to an increased generation of
reactive oxygen species or free radicals. Non enzymic
metabolic antioxidants are generally decreased in various
types of cancers. Intergroup comparison of plasma levels
of glutathione, albumin and ascorbic acid in between
Table 1. Comparison between control group and case
group.
Parameters studied Group I
(30) Group II (30) Group III (30)
Glutathione (mg/d L) 38 ± 7.2 22 ± 9.1 20 ± 10.3
Albumin (g/dL) 4.5 ± 0.3 3.0 ± 0.44 2.9 ± 0.5
Ascorbic acid (mg/dL)0.9 ± 0.15 0.55 ± 0.14 0.45 ± 0.1
Table 2. Group comparison and level of significance.
Parameter Group
Comparison
between
Level of
Significance
P values
GLUTATHIONE I and II
I and III
II and III
<0.005
<0.005
NS
ALBUMIN I and II
I and III
II and III
<0.005
<0.005
NS
ASCORBIC ACID I and II
I and III
II and III
<0.005
<0.005
NS
Highly statistically significant increases in glutathione, albumin and ascor-
bic acid levels were observed in Group I as compared to other groups. No
significan t differ ences in gl utathion e, albumin an d ascorbic aci d levels were
observed in a group comparison between Group II and Group III.
different age groups in breast cancer patients shows that
there is no characteristic difference in significance. Epi-
demiological evidence shows that people who consume
large amounts of fruits and vegetables have reduced risk
of many types of cancer. Antioxidant nutrients present in
various fruits and vegetables that one may consume may
be responsible for some of the protective effects ob-
served in control group [12-14], (Figure 1 [15]).
4. Conclusion
Oxidative stress arises when there is an imbalance be-
tween oxygen free radical formation and scavenging by
antioxidants. Excess generation of free radicals causes
damage to cellular biomolecules which results in lipid
peroxidation, mutagenesis and carcinogenisis. Their chief
danger comes from the damage they can do when they
react with important cellular components such as DNA,
or the cell membrane. To prevent free radical damage, the
body has a defense system of antioxidants. Antioxidants
act as scavengers of free radicals and promote cell to
carry out apoptosis. This study was aimed to evaluate the
status of glutathione, albumin and ascorbic acid in cancer
patients. Statistical analysis show ed significant decline in
these metabolic antioxidants in cancer patients when
compared to control. It remains unclear whether the indi-
viduals with low antioxidant levels are predisposed to
malignancy or whether in malign anc y such a con d ition of
low antioxidant levels is occurring. The results obtained

Evaluation of Glutathione, Albumin and Ascorbic Acid Levels in Breast Cancer Patients 407
Formation of Non-toxic Products
Deactivation by induction of
enzymes by bioantimutagens
(Dietary)
CARCINOGEN
AIR/FOO D/WATER
PROCARCINOGEN
OXIDATIONS
REACTI VE ELECTROPHILES
MUTAGENS
Excretion Non-toxic
ATTACK TARGET SITE
Protection of Cellular DNA by
bioantimutagens (Dietary)
INITIATION
DNA ADDUCTS
PROGRESSION
PRENEOPLASIA
PROMOTION
NEOP L ASIA
Antipromoters (Dietary)
NEOPLASIA
Figure 1. Role of dietary factors in carcinogenic process [15].
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Radical-Induced Damage to DNA: Mechanisms and Meas-
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