Department of Surgery, Fukuoka Seisyukai Hospital, Fukuoka, 811-2316, Japan.
Department of Surgery, National Hospital Organization, Saga Hospital, Saga, Japan.
BMC Cancer. 2021 Apr 20;21(1):434. doi: 10.1186/s12885-021-08147-2.
Interactions between adipocyte and breast cancer (BC) cells have yet to be fully elucidated. Here we investigated the prognostic impact of marginal adipose tissue invasion in both luminal breast cancer (HR+/HER2-) and triple-negative breast cancer (TNBC) (HR-/HER2-).
A total of 735 patients with early-stage invasive BC (1999-2014) were retrospectively registered. Median length of patient follow-up was 8.9 years. Survival curves were calculated using a Kaplan-Meier cumulative survival plot. The prognostic difference between two groups were assessed by the univariate Cox-proportional hazard regression model.
Patients with adipose tissue invasion (n = 614) had a significantly poorer prognosis than those without adipose tissue invasion (n = 121) in overall survival (OS) (hazard ratio, 2.1; 95% Confidence interval [CI], 1.1 to 4.0; P = 0.025). While a poorer prognosis was observed in TNBC (n = 137) than in luminal BC patients (n = 496) (hazard ratio, 0.45; 95% CI, 0.30 to 0.68, P < 0.001), this aggressive nature of TNBC was noted in node-positive disease (hazard ratio, 0.3; 95% CI, 0.18 to 0.5, P < 0.001) but not in node-negative disease (hazard ratio, 0.78; 95% CI, 0.39 to 1.55, P = 0.472), and also noted in adipose tissue invasion-positive patients (hazard ratio, 0.4; 95% CI, 0.26 to 0.6, P < 0.001) but not in adipose tissue invasion-negative patients (hazard ratio, 0.73; 95% CI, 0.16 to 3.24, P = 0.675). In addition, although patients suffering from TNBC with adipose tissue invasion had a poorer outcome than those without adipose tissue invasion (hazard ratio, 3.63; 95% CI, 1.11 to 11.84; P = 0.033), the difference was not observed in luminal BC (hazard ratio, 1.75; 95% CI, 0.64 to 4.82; P = 0.277).
Adipose tissue invasion was correlated with poor survival in TNBC. Cancer cell invasion into local fat may be a first step on cancer progression and systemic disease in TNBC.
脂肪细胞与乳腺癌（BC）细胞之间的相互作用尚未完全阐明。在这里，我们研究了边缘脂肪组织浸润对腔性乳腺癌（HR+/HER2-）和三阴性乳腺癌（TNBC）（HR-/HER2-）的预后影响。
回顾性登记了 735 例早期浸润性 BC 患者（1999-2014 年）。中位患者随访时间为 8.9 年。使用 Kaplan-Meier 累积生存图计算生存曲线。通过单因素 Cox 比例风险回归模型评估两组间的预后差异。
与无脂肪组织浸润的患者（n=121）相比，有脂肪组织浸润的患者（n=614）的总生存（OS）（风险比，2.1；95%置信区间[CI]，1.1 至 4.0；P=0.025）明显较差。TNBC 患者（n=137）的预后较腔性 BC 患者（n=496）更差（风险比，0.45；95%CI，0.30 至 0.68，P<0.001），但在淋巴结阳性疾病中观察到 TNBC 的侵袭性（风险比，0.3；95%CI，0.18 至 0.5，P<0.001）而在淋巴结阴性疾病中则没有（风险比，0.78；95%CI，0.39 至 1.55，P=0.472），在脂肪组织浸润阳性患者中也观察到这种情况（风险比，0.4；95%CI，0.26 至 0.6，P<0.001），而在脂肪组织浸润阴性患者中则没有（风险比，0.73；95%CI，0.16 至 3.24，P=0.675）。此外，尽管患有 TNBC 且有脂肪组织浸润的患者预后较无脂肪组织浸润的患者差（风险比，3.63；95%CI，1.11 至 11.84；P=0.033），但在腔性 BC 中未观察到这种差异（风险比，1.75；95%CI，0.64 至 4.82；P=0.277）。
脂肪组织浸润与 TNBC 的生存不良相关。癌细胞浸润到局部脂肪可能是 TNBC 癌症进展和全身疾病的第一步。
