Invasive ductal breast cancer (IDC) is a heterogeneous disease. Staging and immunohistochemistry allow adequate treatment but it is not yet ideal. Women with Luminal B tumors show an erratic response to treatment. The aim of this study is to improve the prognostic stratification of Luminal B patients.
A prospective study with 234 women with IDC, grouped by TNM and immunohistochemistry in subtypes Luminal A and B, HER2 and Triple Negative, for analysis of survival and its correlations with neutrophils/lymphocytes by hemogram. An equitable selection of 1/3 of these patients, between stages and subtypes, was analyzed for correlations of serum expressions of 7 CC-chemokines, 6 CXC-chemokines, and 3 cytokines; and analysis of TCD8+ and TCD4/FOXP3+ lymphocytes in the tumor microenvironment.
Overall survival was significantly dependent on staging and tumor subtypes. There was correlation of age with IL-6 (r=+0.243;p=0.037), IL-10 (r=+0.304;p=0.009) and IP10/CXCL10 (r=+0.412;p=0.011). There was a correlation between BMI and the chemokine Rantes/CCL5 (r =-0.334; p=0.009). Kaplan-Meier curves showed that Luminal B patients with neutrophil/lymphocyte ratio >2 (Log-Rank p=0.005), or lower expression of ENA78/CXCL5 (≤239.69pg/ml) (Log-Rank p=0.016) and high expression of MIP1β/CCL4 (>34.53pg/ml) (Log-Rank p=0.017) in the serum, or TCD4 lymphocytes >30% (Log-Rank p=0.027) and TCD4+TCD8 lymphocytes >75% (Log-Rank p=0.033) infiltrators in the tumor microenvironment had higher risk of metastasis/death.
Luminal B patients can be better stratified both by blood count and/or serum chemokine analysis and by infiltration of T lymphocytes into the tumor, opening new target-specific therapeutic approaches, in addition to chemotherapy and hormone therapy.
The authors.
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All authors have declared no conflicts of interest.