Keywords
lymphocytic infiltration
CD68 macrophages
CD4/CD8
triple-negative breast cancer
tumor microenvironment
How to Cite
Abstract
In press
Background. Secondary edematous breast cancers (SEBC) are characterized by an aggressive clinical course and require in-depth study of their molecular and biological features, among which the tumor immune microenvironment plays a key role. Analysis of infiltration by immunocompetent cells can reveal new prognostic markers and therapeutic targets.
Aim. To investigate the features of infiltration by CD4+, CD8+, CD20+ lymphocytes and CD68+ macrophages in secondary edematous breast cancers compared to non-edematous forms (NEBC) and to evaluate their association with clinical and pathological parameters and metastatic potential.
Materials and Methods. A comprehensive pathomorphological and immunohistochemical study of 45 cases of breast cancer was conducted: 30 cases of SEBC (main group) and 15 cases of locally advanced NEBC (comparison group). Quantitative assessment of infiltration by the specified cell types and analysis of their correlation with molecular subtype, presence of lymphogenous metastases, and other characteristics were performed.
Research Ethics. The study was conducted in accordance with the ethical standards of the World Medical Association's Declaration of Helsinki (1964–2024), European Community Directive 86/609 on the participation of humans in biomedical research, and Order No.690 of the Ministry of Health of Ukraine dated September 23, 2009. Informed consent was obtained from all participants.
Results. It was found that SEBC is characterized by a significantly higher level of CD68+ macrophage infiltration compared to NEBC (p<0.05). The highest macrophage density was found in the triple-negative SEBC subgroup, which correlated with a more aggressive course (p<0.001). A CD4/CD8 ratio ≥1.5 was significantly more frequent in SEBC (46.6% vs. 13.3% in NEBC, p<0.05) and was associated with the presence of metastases in regional lymph nodes (p<0.03). Absolute counts of CD4+, CD8+, and CD20+ cells did not show significant differences between groups or clear prognostic value.
Conclusions. The obtained results indicate a pathogenetically important role of macrophage infiltration in the development of aggressive forms of SEBC, especially the triple-negative subtype. The CD4/CD8 ratio is defined as a promising prognostic indicator of lymphogenous metastasis in SEBC. These findings justify the feasibility of further study of the immune microenvironment for risk stratification and development of personalized immunotherapeutic strategies for patients with secondary edematous breast cancers.
Keywords: oncology, lymphocytic infiltration, CD68+ macrophages, CD4/CD8, triple-negative breast cancer, tumor microenvironment.
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