Abstract：
BACKGROUND: Triple-negative breast cancer (TNBC) is an aggressive cancer subtype, with limited treatments and a high metastasis risk. The varying location of metastasis in TNBC patients often leads to in prognosis in breast cancer. Therefore, this study aimed to investigate the potential association between immune cells profiles in the tumor microenvironment and metastatic patterns.
METHODS: We conducted a multicenter cross-sectional study in 2022 to examine formalin-fixed paraffin-embedded (FFPE) and medical record data from 2015 to 2020 in de novo metastatic TNBC patients. The medical records provided crucial information about the sites of metastasis. Immunohistochemistry (IHC) analysis was carried out on primary breast tumor tissues to evaluate the expressions of cluster of differentiation (CD)4 T-cells, CD8 T-cells, CD163, FOXP3 Tregs, and programmed death-ligand 1 (PD-L1), along with immune cells ratios showing antitumor-to-protumor activity (CD4/FOXP3, CD8/FOXP3, CD4/CD163, CD8/CD163). Metastatic locations were grouped into bone-only, visceral, lung, liver, and brain metastasis. Results: A total of 120 metastatic TNBC patients were documented for their metastatic location and IHC report. The clinical and histopathological characteristics showed that the majority of the patients were within the 40-65 years old group, and 34.2% had standard body mass index (BMI). Furthermore, the majority (89.22%) of the patients showed No Special Type (NST), (56.7%) had histopathology grade III, high Ki-67 ≥20% (85.8%), and positive PD-L1 expression (30.8%), with visceral metastasis indicating the highest proportion of 75.8%. Patients with a high CD8/FOXP3 and CD4/FOXP3 ratio were significantly prone to have bone-only metastasis compared to visceral metastasis (p= 0.028 and p=0.024, respectively). Conclusion: The ratio of antitumor to protumor T-lymphocytes had a significant relevance in the metastatic location patterns in TNBC.
METHODS: We conducted a multicenter cross-sectional study in 2022 to examine formalin-fixed paraffin-embedded (FFPE) and medical record data from 2015 to 2020 in de novo metastatic TNBC patients. The medical records provided crucial information about the sites of metastasis. Immunohistochemistry (IHC) analysis was carried out on primary breast tumor tissues to evaluate the expressions of cluster of differentiation (CD)4 T-cells, CD8 T-cells, CD163, FOXP3 Tregs, and programmed death-ligand 1 (PD-L1), along with immune cells ratios showing antitumor-to-protumor activity (CD4/FOXP3, CD8/FOXP3, CD4/CD163, CD8/CD163). Metastatic locations were grouped into bone-only, visceral, lung, liver, and brain metastasis. Results: A total of 120 metastatic TNBC patients were documented for their metastatic location and IHC report. The clinical and histopathological characteristics showed that the majority of the patients were within the 40-65 years old group, and 34.2% had standard body mass index (BMI). Furthermore, the majority (89.22%) of the patients showed No Special Type (NST), (56.7%) had histopathology grade III, high Ki-67 ≥20% (85.8%), and positive PD-L1 expression (30.8%), with visceral metastasis indicating the highest proportion of 75.8%. Patients with a high CD8/FOXP3 and CD4/FOXP3 ratio were significantly prone to have bone-only metastasis compared to visceral metastasis (p= 0.028 and p=0.024, respectively). Conclusion: The ratio of antitumor to protumor T-lymphocytes had a significant relevance in the metastatic location patterns in TNBC.
摘要：
背景：三阴性乳腺癌（TNBC）是一种侵袭性癌症亚型，有限的治疗和高转移风险。TNBC患者转移部位的不同常导致乳腺癌的预后。因此,本研究旨在探讨肿瘤微环境中免疫细胞谱与转移模式之间的潜在关联。
方法：我们在2022年进行了一项多中心横断面研究，以检查2015年至2020年新转移性TNBC患者的福尔马林固定石蜡包埋（FFPE）和病历数据。医疗记录提供了有关转移部位的重要信息。对原发性乳腺肿瘤组织进行免疫组织化学（IHC）分析，以评估分化簇（CD）4T细胞的表达。CD8T细胞，CD163,FOXP3Tregs,和程序性死亡配体1(PD-L1)，以及显示抗肿瘤与质子活性的免疫细胞比率（CD4/FOXP3，CD8/FOXP3，CD4/CD163，CD8/CD163）。转移部位分为仅骨，内脏，肺，肝脏,和脑转移。结果：记录了120例转移性TNBC患者的转移位置和IHC报告。临床及组织病理学特征显示,大部分患者在40-65岁人群中,34.2%有标准体重指数(BMI)。此外，大多数（89.22%）患者表现为非特殊类型（NST），（56.7%）有组织病理学III级，高Ki-67≥20%（85.8%），PD-L1阳性表达（30.8%），以内脏转移者占比最高，为75.8%。与内脏转移相比，CD8/FOXP3和CD4/FOXP3比率高的患者明显容易发生仅骨转移（分别为p=0.028和p=0.024）。结论：抗肿瘤T淋巴细胞与原瘤T淋巴细胞的比例与TNBC的转移位置模式具有显着相关性。
方法：我们在2022年进行了一项多中心横断面研究，以检查2015年至2020年新转移性TNBC患者的福尔马林固定石蜡包埋（FFPE）和病历数据。医疗记录提供了有关转移部位的重要信息。对原发性乳腺肿瘤组织进行免疫组织化学（IHC）分析，以评估分化簇（CD）4T细胞的表达。CD8T细胞，CD163,FOXP3Tregs,和程序性死亡配体1(PD-L1)，以及显示抗肿瘤与质子活性的免疫细胞比率（CD4/FOXP3，CD8/FOXP3，CD4/CD163，CD8/CD163）。转移部位分为仅骨，内脏，肺，肝脏,和脑转移。结果：记录了120例转移性TNBC患者的转移位置和IHC报告。临床及组织病理学特征显示,大部分患者在40-65岁人群中,34.2%有标准体重指数(BMI)。此外，大多数（89.22%）患者表现为非特殊类型（NST），（56.7%）有组织病理学III级，高Ki-67≥20%（85.8%），PD-L1阳性表达（30.8%），以内脏转移者占比最高，为75.8%。与内脏转移相比，CD8/FOXP3和CD4/FOXP3比率高的患者明显容易发生仅骨转移（分别为p=0.028和p=0.024）。结论：抗肿瘤T淋巴细胞与原瘤T淋巴细胞的比例与TNBC的转移位置模式具有显着相关性。
