Abstract
AIMS: To evaluate the immune risk profile of elderly women with breast cancer and to assess whether this can be a reliable predictor to determine types of treatment and oncologic follow-up. METHODS: We assessed the CD4+/CD8+ ratio in peripheral blood cell, as well as serology for cytomegalovirus, of 37 women who were aged 60 years or more at the time they were diagnosed with breast cancer/. They all had surgical treatment at the Breast Center from Pontificia Universidade Catolica do Rio Grande do Sul. Those with positive serology for HIV, or immuno-suppressed due to organ transplant, as well as those who had neoadjuvant chemotherapy. Data was analyzed according to axillary involvement, tumor size, tumor immunohistochemical profile and occurrence of adverse events (axillary relapse, local relapse and/or metastases) RESULTS: The mean value of CD4+/CD8+ ratio was 1.72 (min. 1.1, max. 2.32) and cytomegalovirus serology was positive in all subjects. Comparing the groups, patients with positive axillary metastases (n=10) had a CD4+/CD8+ ratio greater than in those with negative axillary metastases (p=0.04). No statistically significant difference was detected regarding the size and immunohistochemical profile of the tumor. Two adverse events occurred at a mean follow-up of 14 months (one axillary relapse and one bone metastasis), when an increase in the CD4+/CD8+ ratio was observed. CONCLUSIONS: The CD4+/CD8+ ratio appear to increase in cases of breast cancer with worst prognosis. As far as was possible to search, these are the first data on CD4+ and CD8+ peripheral blood of elderly women with breast cancer. A longer follow-up will determine the value of these cells as a prognostic and/or predictive marker.
Highlights
Data was analyzed according to axillary involvement, tumor size, tumor immunohistochemical profile and occurrence of adverse events
The mean value of CD4+/CD8+ ratio was 1.72 and cytomegalovirus serology was positive in all subjects
Two adverse events occurred at a mean follow-up of 14 months, when an increase in the CD4+/CD8+ ratio was observed
Summary
Betina Vollbrecht[1,2], Felipe Pereira Zerwes[2,3,4], Janaína Ferreira Viegas[2,3], Thiago Willers[2,4], Ana Paula Ornaghi[5], Cristina Bonorino[5], Antonio Luiz Frasson[1,2,4]. Objetivos: Avaliar o perfil imunológico de risco em idosas com câncer de mama e testar se este pode ser um fator preditivo confiável para determinar tipos de tratamento e seguimento oncológico. Métodos: Foram pesquisadas a relação das células T CD4+/CD8+ e a sorologia para citomegalovírus no sangue periférico de mulheres com 60 anos ou mais de idade no momento do diagnóstico da neoplasia mamária, que realizaram tratamento cirúrgico no Centro de Mama da Pontifícia Universidade Católica do Rio Grande do Sul pelo Sistema Único de Saúde. As pacientes com axila positiva para metástases apresentaram uma relação CD4+/CD8+ maior que nos casos de axila negativa para metástases (p=0,04). No seguimento médio de 14,3 meses, ocorreram dois eventos adversos (uma recidiva axilar e um caso de metástases ósseas), quando se observou um aumento na relação das células T pesquisadas. DESCRITORES: LINFÓCITOS T CD4-POSITIVOS; LINFÓCITOS T CD8-POSITIVOS; RELAÇÃO CD4-CD8; CÂNCER DE MAMA/imunologia; GERIATRIA
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