Abstract
BackgroundTo assess the distribution characteristics and the prognostic value of immune infiltration in female oligometastatic breast cancer patients.MethodsWe retrospectively analyzed the clinicopathological data of oligometastatic breast cancer (OMBC) patients diagnosed between June 2000 and January 2020. Immune markers were quantified by immunohistochemistry on FFPE tissues in paired normal breast tissues, primary breast cancers and oligometastatic lesions. Survival analyses were performed using the Kaplan-Meier curves and Cox-proportional hazards model.ResultsA total of 95 female OMBC patients visited Sun Yat-sen University Cancer Center between June 2000 and January 2020, and 33 of them had matched normal breast tissues, primary cancers and oligometastatic lesions and were reviewed in immune infiltration analysis. CD8 of primary tumors had a higher expression than that in matched normal tissues. The expressions of CD8 and FOXP3 were higher in the primary sites than that in the oligometastatic lesions. CD3, CD4 and CD8 were significantly lower in the intratumoral regions than that in the peritumoral regions both in primary and oligometastatic lesions. Notably, the high percentage of CD3 in the intratumoral oligometastatic lesions predicted the longer PFS and OS, and higher CD4 in the same lesions also predicted a better OS. There was obviously positive correlation between CD4/CD3 and Ki-67 in primary cancers and negative correlation between CD4/CD3 and ER in oligometastatic sites.ConclusionWe explored immune distribution and evolution in time and space in OMBC to provide new understandings for biological behaviors of this disease and further divided patients in different prognosis.
Highlights
Breast cancer remains the most commonly diagnosed female malignant tumor with the highest incidence and mortality in 2020 worldwide [1]
Inclusion criteria were as follows: female breast cancer patients with histologically confirmed diagnosis; metastatic disease diagnosed by pathology; no more than 5 metastatic lesions identified by imaging, including contrast-enhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) and/or positron emission tomography/ computed tomography (PET/CT); patients with sufficient pathological tissue to perform immunohistochemistry (IHC)
There were 40 hormone receptor (HR)+ HER2- breast cancer, 40 HER2+ cancers and 10 triple negative breast cancer (TNBC) patients based on the primary tumor
Summary
Breast cancer remains the most commonly diagnosed female malignant tumor with the highest incidence and mortality in 2020 worldwide [1]. 20-30% of breast cancer patients may occur metastases after diagnosis and primary tumor treatment [2, 3], and the 5-year overall survival (OS) rate of metastatic breast cancer (MBC) patients is only 25% [4]. The oligometastatic breast cancer (OMBC) represents a special condition [6] and develops in about 1-10% of new MBC [7, 8]. Since no biomarker for the identification of patients with different prognoses is clinically available, the evaluation of oligometastatic disease is based solely on imaging findings and this manifestation on imaging could represent different clinical scenarios and might require different treatment strategies. To assess the distribution characteristics and the prognostic value of immune infiltration in female oligometastatic breast cancer patients
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