Cai Dongyan, Wu Xiaohong, Hong Tingting, Mao Yong, Ge Xiaosong, Hua Dong
Department of Oncology, The Fourth People's Hospital of Wuxi, No. 200, Huihe road, Wuxi 214062, China.
Department of Oncology, The Fourth People's Hospital of Wuxi, No. 200, Huihe road, Wuxi 214062, China.
Pathol Res Pract. 2017 Oct;213(10):1296-1301. doi: 10.1016/j.prp.2017.06.016. Epub 2017 Jun 30.
During the epithelial tumor development process, changes in tumor cell genes are an important driving factor for tumorigenesis. Recently, however, studies have shown that the tumor microenvironment, especially for cancer-associated fibroblasts (CAFs) and the infiltration of platelets into tumors, plays an essential role in the progression of human malignant disease.
In this study, we investigated the presence and prognostic role of podoplanin-expressing CAFs (CAF+), the infiltration of platelets into tumors (CD61+) and platelet count before surgery in a large sample of patients with breast cancer. Podoplanin expression and platelet infiltration were evaluated by immunohistochemistry in 164 patients with breast cancer.
Seventy-two patients (44%) showed CAF+, while fifty-seven patients (35%) showed CD61+. Several strong positive correlations were found, including CD61+ with blood platelet count before surgery (P=0.004), and CAF+ with CD61+ (P=0.048). Patients with CAF+, CD61+ or platelet count >280×10/L before surgery had a significantly shorter disease-free survival according to univariate analysis. Multivariable analysis showed that CAF+ was an independent prognostic factor (Hazard ratio=3.928; p=0.005).
CAF+ and CD61+ were found to be good negative prognosis factors for invasive breast cancer patients. CD61+ also had strong positive correlation with blood platelet count before surgery. These targets may be used as strategies for the treatment of breast cancer in the future.
在上皮性肿瘤发展过程中,肿瘤细胞基因变化是肿瘤发生的重要驱动因素。然而,最近的研究表明,肿瘤微环境,尤其是癌症相关成纤维细胞(CAFs)以及血小板向肿瘤的浸润,在人类恶性疾病进展中起重要作用。
在本研究中,我们调查了大量乳腺癌患者中表达血小板内皮细胞黏附分子-1的CAFs(CAF+)的存在情况及其预后作用、血小板向肿瘤的浸润(CD61+)以及术前血小板计数。通过免疫组织化学对164例乳腺癌患者评估血小板内皮细胞黏附分子-1表达和血小板浸润情况。
72例患者(44%)显示CAF+,57例患者(35%)显示CD61+。发现了几个强正相关,包括CD61+与术前血小板计数(P=0.004),以及CAF+与CD61+(P=0.048)。单因素分析显示,术前有CAF+、CD61+或血小板计数>280×10⁹/L的患者无病生存期明显较短。多因素分析显示,CAF+是一个独立的预后因素(风险比=3.928;P=0.005)。
发现CAF+和CD61+是浸润性乳腺癌患者的不良预后因素。CD61+也与术前血小板计数呈强正相关。这些靶点未来可能用作乳腺癌的治疗策略。