Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer

Abstract The treatment of breast cancer (BC) has improved greatly in recent years, however, the limitations of current therapeutic modalities underscore the need to define new prognostic tools and develop highly targeted therapies. The aims of the present study were to explore the effects of circula...

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Main Authors: Jian Yang, Junnan Xu, Ying E, Tao Sun
Format: Article
Language:English
Published: Wiley 2019-02-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.1891
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author Jian Yang
Junnan Xu
Ying E
Tao Sun
author_facet Jian Yang
Junnan Xu
Ying E
Tao Sun
author_sort Jian Yang
collection DOAJ
description Abstract The treatment of breast cancer (BC) has improved greatly in recent years, however, the limitations of current therapeutic modalities underscore the need to define new prognostic tools and develop highly targeted therapies. The aims of the present study were to explore the effects of circulating blood lymphocyte subsets on the survival of metastatic breast cancer (MBC) patients and to evaluate their predictive and prognostic value. The clinical data of 482 patients with MBC were retrospectively analyzed, and patients were grouped according to molecular types of BC. The distribution of peripheral blood lymphocyte subsets at the time of first metastasis was examined by flow cytometry, and the distribution of lymphocyte subsets in each group was categorized into ‘‘high or low’’ subgroups using the upper quartile point as the cutoff. The relationship between the distribution of lymphocyte subsets and progression‐free survival (PFS) as well as overall survival (OS) was evaluated in diverse molecular MBCs. In multivariate analysis, CD4+ was a negative independent predictor of PFS (hazard ratio [HR] = 0.538, 95% confidence interval [CI] = 0.313‐0.926, P = 0.025) and CD3+ was a poor independent prognostic factor for OS (HR = 0.437, 95% CI = 0.248‐0.772, P = 0.004) in the human epidermal growth factor receptor 2 (HER2)‐positive group. Neither the CD8+, CD19+, and CD56+ lymphocyte subsets nor the CD4+/CD8+ ratio in peripheral blood was significant predictive or prognostic factors. In conclusion, higher circulating levels of CD4+ and CD3+ at first diagnosis in HER2‐overexpressing MBC were significantly associated with worse survival outcomes. Low levels of plasma CD4+ and CD3+ were associated with increased anti‐HER2 benefit in HER2‐positive MBC. The present results indicate that these factors can be used as predictive and prognostic indicators of the outcome of patients with MBC.
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spelling doaj.art-090dce0cbe6349379ebe858763bca6352023-07-13T12:30:56ZengWileyCancer Medicine2045-76342019-02-018249250010.1002/cam4.1891Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancerJian Yang0Junnan Xu1Ying E2Tao Sun3Department of Medical Oncology, Cancer Hospital of China Medical University Liaoning Cancer Hospital & Institute Shenyang ChinaDepartment of Medical Oncology, Cancer Hospital of China Medical University Liaoning Cancer Hospital & Institute Shenyang ChinaDepartment of Medical Oncology, Cancer Hospital of China Medical University Liaoning Cancer Hospital & Institute Shenyang ChinaDepartment of Medical Oncology, Cancer Hospital of China Medical University Liaoning Cancer Hospital & Institute Shenyang ChinaAbstract The treatment of breast cancer (BC) has improved greatly in recent years, however, the limitations of current therapeutic modalities underscore the need to define new prognostic tools and develop highly targeted therapies. The aims of the present study were to explore the effects of circulating blood lymphocyte subsets on the survival of metastatic breast cancer (MBC) patients and to evaluate their predictive and prognostic value. The clinical data of 482 patients with MBC were retrospectively analyzed, and patients were grouped according to molecular types of BC. The distribution of peripheral blood lymphocyte subsets at the time of first metastasis was examined by flow cytometry, and the distribution of lymphocyte subsets in each group was categorized into ‘‘high or low’’ subgroups using the upper quartile point as the cutoff. The relationship between the distribution of lymphocyte subsets and progression‐free survival (PFS) as well as overall survival (OS) was evaluated in diverse molecular MBCs. In multivariate analysis, CD4+ was a negative independent predictor of PFS (hazard ratio [HR] = 0.538, 95% confidence interval [CI] = 0.313‐0.926, P = 0.025) and CD3+ was a poor independent prognostic factor for OS (HR = 0.437, 95% CI = 0.248‐0.772, P = 0.004) in the human epidermal growth factor receptor 2 (HER2)‐positive group. Neither the CD8+, CD19+, and CD56+ lymphocyte subsets nor the CD4+/CD8+ ratio in peripheral blood was significant predictive or prognostic factors. In conclusion, higher circulating levels of CD4+ and CD3+ at first diagnosis in HER2‐overexpressing MBC were significantly associated with worse survival outcomes. Low levels of plasma CD4+ and CD3+ were associated with increased anti‐HER2 benefit in HER2‐positive MBC. The present results indicate that these factors can be used as predictive and prognostic indicators of the outcome of patients with MBC.https://doi.org/10.1002/cam4.1891CD3CD4lymphocytesmetastatic breast cancersurvival
spellingShingle Jian Yang
Junnan Xu
Ying E
Tao Sun
Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer
Cancer Medicine
CD3
CD4
lymphocytes
metastatic breast cancer
survival
title Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer
title_full Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer
title_fullStr Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer
title_full_unstemmed Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer
title_short Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer
title_sort predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer
topic CD3
CD4
lymphocytes
metastatic breast cancer
survival
url https://doi.org/10.1002/cam4.1891
work_keys_str_mv AT jianyang predictiveandprognosticvalueofcirculatingbloodlymphocytesubsetsinmetastaticbreastcancer
AT junnanxu predictiveandprognosticvalueofcirculatingbloodlymphocytesubsetsinmetastaticbreastcancer
AT yinge predictiveandprognosticvalueofcirculatingbloodlymphocytesubsetsinmetastaticbreastcancer
AT taosun predictiveandprognosticvalueofcirculatingbloodlymphocytesubsetsinmetastaticbreastcancer