Value Of FOXP3 Tregs Predicting The Effectiveness Of Neoadjuvant Chemotherapy In Patients With Breast Cancer

Background and objectiveThe development and progression of malignant tumor has a close relationship with immune system, in which regulatory T cells(Treg cells) are important subgroup for negative immune response. In the development and progression of tumor, Treg cells can inhibit the anti-tumor immune response, leading to tumor immune escape. FOXP3(forkhead box P3)is a protein encoding by forkhead/winged-helix transcription factor and act as a specific marker of Treg cell. FOXP3 have been detected increases in a variety of malignant tumors, and play an important role in the function of Treg cells. Neoadjuvant chemotherapy is widely used in a variety of malignant tumors and has huge advantages compared with Other treatments.It can make the tumors shrink, and lower clinical stage. It can also verify the feasibility and sensitivity to chemotherapy regimens. But Neoadjuvant chemotherapy lack suitable molecular markers to predict individual curative effect. A large number of studies confirm that only getting p CR in the neoadjuvant chemotherapy, can patients have a extended overall survival. So it is gold standard to get a p CR in evaluating the efficacy of neoadjuvant chemotherapy. The objective of this study is to explore the predictive significance of FOXP3 Tregs in patients with breast cancer treated with neoadjuvant chemotherapy through the analysis of specimens FOXP3 + Tregs of 78 cases of breast cancer before neoadjuvant chemotherapy and 25 cases of normal breast tissue, 40 cases of breast benign tumor from the first affiliated hospital of Zhengzhou university. MethodsA total of 78 specimens of newly diagnosed, untreated patients with invasive breast cancer and 25 cases of normal breast tissue, 40 cases of breast benign tumor from the first affiliated hospital of Zhengzhou university were included into this retrospective study.FOXP3 Tregs were assessed by immunohistochemistry. The relationship between the clinicopathological factors including age、 tumor size 、histological grading、ER、PR、Her-2、 armpit lymph noodle metastasis,FOXP3+ Tregs and the pathological complete response( p CR) rate was analyzed. Results 1. In breast cancer,the positive rate of the expression of FOXP3 is 84.6 %,higher than that in benign lesions 35.00% and normal breast tissues 12.00%. There is statistical significance in the difference(P<0.0001). 2. The positive rate of the expression of FOXP3 in histological grade Ⅲ is higher than that in histological grade Ⅱ and Ⅰ. There is statistical significance in the difference(P=0.033). The positive rate of expression of FOXP3 in the bigger tumor size group is higher than that of smaller tumor size. The positive rate of FOXP3 of the lymph node metastasis group is higher than that of the no lymph node metastasis group. There is statistical significance in the difference (P<0.029). There is no statistical significance between the positive rate of FOXP3 and age、ER、PR、Her-2(P>0.05). 3. Of the 78 patients with TAC neoadjuvant chemotherapy,the p CR rate was19.2%.The p CR rate of patients with high expressions of FOXP3+ Tregs was significantly lower than that of patients with low expressions of FOXP3+ Tregs ( 9.5% vs 30.5%,P = 0.023).FOXP3+ Tregs expression in breast cancer and the efficacy of NACT were negatively correlated. Conclusions 1. There were higher expression of FOXP3 in breast cancer. 2. There is no statistical significance between the positive rate of FOXP3 and age、ER、PR、Her-2,but tumor size、histological grade、clinical stage、Lymph node metastasis. 3.FOXP3+ Tregs can be used as a predictor to assess the efficacy of NACT.