Analysis Of The Prediction And Prognostic Value Of Peripheral Blood Lymphocyte Subsets In Metastatic Breast Cancer

Objective: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.Methods: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.Results: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.Conclusion: In HER-2 positive MBC patients,the high proportion of CD4+ and CD3+ in peripheral blood is associated with poor PFS and OS,respectively,and can be used as a predictor and prognostic indicator for survival in patients with MBC.In addition,in HER2-positive disease,low levels of CD3+ and CD4+ distribution in peripheral blood may increase the clinical benefit of anti-HER2 therapy..