Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Int J Surg. 2017 Sep;45:72-76. doi: 10.1016/j.ijsu.2017.07.080. Epub 2017 Jul 25.
We aimed to demonstrate the prognostic value of TGF-β1 in triple negative breast cancer (TNBC) and its association with clinicopathological characteristics of TNBC.
A total of 180 women were randomly selected from non-metastatic invasive TNBC patients diagnosed at two hospitals between 2003 and 2012. Lmmunohistochemistry was performed to semi-quantify the expression of TGF-β1. Relationship between TGF-β1 expression and clinicopathological features was performed by Chi-square test. Univariate and multivariate survival analyses were performed to identify the prognostic role of TGF-β1 expression on survival outcomes.
Of the 180 women included in this study, 67 (37.2%) patients expressed high level of TGF-β1. High expression of cytoplasmic TGF-β1 was correlated with higher histologic tumor grade (P < 0.001) and lymph node status (P < 0.001), and more axillary lymph node dissection (P = 0.029). High cytoplasmic TGF-β1 expression was associated with reduced disease-free survival (DFS) and overall survival (OS) by log-rank test (P<0.001, P = 0.045). However, multivariate survival analyses showed that high TGF-β1 was marginally correlated with unfavorable DFS (hazard ratio (HR) 1.796, 95% CI 0.995-3.242, P = 0.052), while it was not significantly associated with OS (HR 0.747, 95% CI 0.367-1.522, P = 0.422).
This multi-centered retrospective study highlights the high expression of cytoplasmic TGF-β1 in TNBC is associated with higher histologic grade and lymph node status, more axillary lymph node dissection, as well as reduced DFS. Our observation that the prognostic role of TGF-β1 in TNBC suggests potential rationale for using therapeutic strategies based on targeting TGF-β1 in advanced tumors.
本研究旨在探究转化生长因子-β1（TGF-β1）在三阴性乳腺癌（TNBC）中的预后价值及其与 TNBC 临床病理特征的关系。
本研究共纳入了 2003 年至 2012 年间在两家医院确诊的非转移性浸润性 TNBC 患者 180 例，采用免疫组织化学法对 TGF-β1 的表达进行半定量分析。采用卡方检验分析 TGF-β1 表达与临床病理特征的关系。通过单因素和多因素生存分析确定 TGF-β1 表达对生存结果的预后作用。
本研究共纳入 180 例女性患者，其中 67 例（37.2%）患者 TGF-β1 高表达。细胞质 TGF-β1 高表达与较高的组织学肿瘤分级（P<0.001）和淋巴结状态（P<0.001）以及更多的腋窝淋巴结清扫（P=0.029）相关。通过对数秩检验发现，细胞质 TGF-β1 高表达与无病生存（DFS）和总生存（OS）显著相关（P<0.001，P=0.045）。然而，多因素生存分析显示，TGF-β1 高表达与不良 DFS 相关（风险比（HR）1.796，95%可信区间 0.995-3.242，P=0.052），但与 OS 无显著相关性（HR 0.747，95%可信区间 0.367-1.522，P=0.422）。
本多中心回顾性研究表明，TNBC 中细胞质 TGF-β1 的高表达与较高的组织学分级和淋巴结状态、更多的腋窝淋巴结清扫以及较短的 DFS 相关。我们的观察结果表明，TGF-β1 在 TNBC 中的预后作用提示了在晚期肿瘤中基于靶向 TGF-β1 的治疗策略的潜在合理性。
