Abstract
BackgroundBiomarkers of the immune system are currently not used as prognostic factors in breast cancer. We analyzed the association of the B cell/plasma cell marker immunoglobulin kappa C (IGKC) and survival of untreated node-negative breast cancer patients.Material and MethodsIGKC expression was evaluated by immunostaining in a cohort of 335 node-negative breast cancer patients with a median follow-up of 152 months. The prognostic significance of IGKC for disease-free survival (DFS) and breast cancer-specific overall survival (OS) was evaluated with Kaplan-Meier survival analysis as well as univariate and multivariate Cox analysis adjusted for age at diagnosis, pT stage, histological grade, estrogen receptor (ER) status, progesterone receptor (PR) status, Ki-67 and human epidermal growth factor receptor 2 (HER-2) status.Results160 patients (47.7%) showed strong expression of IGKC. Univariate analysis showed that IGKC was significantly associated with DFS (P = 0.017, hazard ratio [HR] = 0.570, 95% confidence interval [CI] = 0.360–0.903) and OS (P = 0.011, HR = 0.438, 95% CI = 0.233–0.822) in the entire cohort. The significance of IGKC was especially strong in ER negative and in luminal B carcinomas. In multivariate analysis IGKC retained its significance independent of established clinical factors for DFS (P = 0.004, HR = 0.504, 95% CI = 0.315–0.804) as well as for OS (P = 0.002, HR = 0.371, 95% CI = 0.196–0.705).ConclusionExpression of IGKC has an independent protective impact on DFS and OS in node-negative breast cancer.
Highlights
For many years researchers have tried to characterize prognostic factors, but have only made limited progress [1]
Univariate analysis showed that immunoglobulin kappa C (IGKC) was significantly associated with disease-free survival (DFS) (P = 0.017, hazard ratio [HR] = 0.570, 95% confidence interval [CI] = 0.360–0.903) and overall survival (OS) (P = 0.011, HR = 0.438, 95% CI = 0.233–0.822) in the entire cohort
The significance of IGKC was especially strong in estrogen receptor (ER) negative and in luminal B carcinomas
Summary
For many years researchers have tried to characterize prognostic factors, but have only made limited progress [1]. Gene-based testing like Oncotype DX, Endopredict or Mamma Print is increasingly used to determine prognosis [2,3,4]. These gene-expression arrays rely largely on proliferation and estrogen receptor (ER) status. It is increasingly recognized that the immune system, especially adaptive immune cells, has a large influence on the prognosis of breast cancer [5,6]. The impact of adaptive cellular immune response, represented by CD8+ T cells, was studied most intensely. Biomarkers of the immune system are currently not used as prognostic factors in breast cancer. We analyzed the association of the B cell/plasma cell marker immunoglobulin kappa C (IGKC) and survival of untreated node-negative breast cancer patients
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