Peng Gong-Ling, Li Liang, Guo Ya-Wen, Yu Pan, Yin Xing-Jie, Wang Shan, Liu Chun-Ping
Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430014, China.
Department of Radiology, Renmin Hospital of Wuhan University Wuhan 430060, China.
Am J Transl Res. 2019 Aug 15;11(8):5039-5053. eCollection 2019.
There is conflicting evidence regarding the prognostic value of cytotoxic T cell infiltration in breast cancer. The aims of this study were to detect the expression levels and localization of FoxP3 and CD8 in invasive ductal carcinoma of the breast and to investigate the correlations among FoxP3 regulatory T cells (Tregs), CD8 cytotoxic T lymphocytes (CTLs), clinicopathological features, and prognosis in patients with breast cancer.
Immunohistochemistry was used to detect the expression levels and localization of FoxP3 and CD8. One-sample -test, one-way analysis of variance, and Kaplan-Meier log-rank tests were used to analyze correlations between the expression levels of CD8 and FoxP3; Kaplan-Meier Log-rank test was used to analyze clinicopathological features to explore the prognostic significance of CD8 and FoxP3 in patients with breast cancer.
FoxP3 expression in the tumor bed was higher than that in the stroma, while CD8 was primarily expressed in the stroma. CD8 expression was associated with favorable prognostic factors. However, FoxP3 expression and an increased ratio of total FoxP3 Tregs to CD8 CTLs were significantly correlated with unfavorable prognostic factors. Additionally, an increased ratio was associated with molecular subtypes (ERHer2, ERHer2, ERHer2, and ERHer2) of breast cancer. Overexpression of FoxP3 and a high FoxP3/CD8 ratio were correlated with poor overall survival (OS) and disease-free survival (DFS). However, CD8 expression only affected OS in patients with breast cancer.
Tumor-infiltrating lymphocytes are localized variously depending on the subtype. CD8 CTLs were associated with a good prognosis, while FoxP3 Tregs were associated with adverse outcomes in patients with breast cancer. CD8 CTLs and FoxP3 Tregs are potential predictive prognostic factors for patients with breast cancer.
关于细胞毒性T细胞浸润在乳腺癌中的预后价值，存在相互矛盾的证据。本研究的目的是检测乳腺癌浸润性导管癌中FoxP3和CD8的表达水平及定位，并探讨FoxP3调节性T细胞（Tregs）、CD8细胞毒性T淋巴细胞（CTLs）、临床病理特征与乳腺癌患者预后之间的相关性。
采用免疫组织化学法检测FoxP3和CD8的表达水平及定位。采用单样本t检验、单因素方差分析和Kaplan-Meier对数秩检验分析CD8和FoxP3表达水平之间的相关性；采用Kaplan-Meier对数秩检验分析临床病理特征，以探讨CD8和FoxP3在乳腺癌患者中的预后意义。
肿瘤床中FoxP3的表达高于基质中的表达，而CD8主要表达于基质中。CD8表达与有利的预后因素相关。然而，FoxP3表达以及总FoxP3 Tregs与CD8 CTLs的比例增加与不利的预后因素显著相关。此外，该比例增加与乳腺癌的分子亚型（ERHer2、ERHer2、ERHer2和ERHer2）相关。FoxP3的过表达和高FoxP3/CD8比例与较差的总生存期（OS）和无病生存期（DFS）相关。然而，CD8表达仅影响乳腺癌患者的OS。
肿瘤浸润淋巴细胞根据亚型不同而定位不同。CD8 CTLs与良好预后相关，而FoxP3 Tregs与乳腺癌患者的不良结局相关。CD8 CTLs和FoxP3 Tregs是乳腺癌患者潜在预测预后因素。
