title: A prognostic risk model for patients with triple negative breast cancer based on stromal natural killer cells, tumor-associated macrophages and growth-arrest specific protein 6.
abstract: The aim of this study was to establish a prognostic risk model for patients with triple negative breast cancer (TNBC). A total of 278 specimens of human TNBC tissues were investigated by immunohistochemistry for growth-arrest specific protein 6 expression, infiltrations of stromal natural killer cells and tumor-associated macrophages. According to their prognostic risk scores based on the model, patients were divided into three groups (score 0, 1-2, 3). Correlations of prognostic risk scores, clinicopathologic features and overall survival (OS) were analyzed. To study the clinical value of this stratification model in early disease recurrence or metastasis, 177 patients were screened out for further analysis. Based on disease free survival (DFS), 90 patients fell within the DFS ≤3 years group and 87 patients within the DFS ≥5 years group. We analyzed the differences in prognostic risk scores between the two groups. The prognostic risk scores were negatively related to tumor size, lymph node metastasis and P53 status (P < 0.001 for all). Patients with low prognostic risk scores had longer OS (P = 0.001). Using multivariate analysis, it was determined that TNM stage (HR = 0.432, 95% confidence interval [CI] = 0.281-0.665, P = 0.003), FOXP3 positive lymphocytes (HR = 1.712, 95% CI = 1.085-2.702, P = 0.021) and prognostic risk scores (HR = 1.340, 95% CI = 1.192-1.644, P = 0.005) were independent prognostic factors for OS. Compared with the DFS ≥5 years group, the DFS ≤3 years group patients had significantly higher prognostic risk scores (P < 0.001). In conclusion, the prognostic risk score of the model was a significant indicator of prognosis for patients with TNBC.
authors.affiliation: Department of Medical Oncology, Cancer Hospital of Harbin Medical University, Harbin, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Tian
authors.affiliation: Department of Medical Oncology, Cancer Hospital of Harbin Medical University, Harbin, China.
authors.forename: Le
authors.initials: L
authors.lastname: Wang
authors.affiliation: Cancer Research Institute of Heilong Jiang Province, Harbin, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Yuan
authors.affiliation: Department of Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Wenming
authors.initials: W
authors.lastname: Duan
authors.affiliation: Department of Medical Oncology, Cancer Hospital of Harbin Medical University, Harbin, China.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Pathology, Cancer Hospital of Harbin Medical University, Harbin, China.
authors.forename: Shuhuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Cancer Hospital of Harbin Medical University, Harbin, China.|Oncology Key Lab of Heilongjiang Province Institution of Higher Education, Harbin, China.
authors.forename: Qingyuan
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism*; D007694:Killer Cells, Natural / Q000276:immunology* / Q000473:pathology; D008264:Macrophages / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D017154:Stromal Cells / Q000276:immunology*; D064726:Triple Negative Breast Neoplasms / Q000175:diagnosis* / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D019139:Tumor Escape / Q000276:immunology*; D059016:Tumor Microenvironment; D000099255:Growth Arrest-Specific Protein 6
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; D000099255:Growth Arrest-Specific Protein 6
keywords: Growth-arrest specific gene 6; natural killer cell; prognostic predictor; triple negative breast cancer; tumor-associated macrophages