Predictive Role Of Tumor-associated Macrophages In Primary Tumors And Metastatic Lymph Nodes Of Triple-negative Breast Cancer On The Effect Of Neoadjuvant Chemotherapy

Objective:Tumor-associated macrophages(TAMs)are an important part of the tumor microenvironment of breast cancer and participate in the whole process of tumor proliferation,invasion and metastasis.This article explores the predictive effect of CD68~+and CD163~+TAMs in the primary tumor and metastatic axillary lymph nodes of triple-negative breast cancer(TNBC)on the effect of neoadjuvant chemotherapy in order to find potential prognostic indicators and new therapeutic targets for TNBC.Methods:A random collection of 61 TNBC patients who underwent neoadjuvant chemotherapy and completed the operation in the Fourth Hospital of Hebei Medical University from January 2016 to December 2019 were collected to obtain complete clinicopathological data,and all patients were followed up.The primary tumors and axillary lymph node puncture paraffin tissues and the primary tumors and lymph node tissue masses in the surgical specimens of the enrolled patients before neoadjuvant therapy were used for CD68~+,CD163~+TAMs immunohistochemical staining with the Benchmark.XT automatic staining instrument.Analyze the relationship between TAMs expression and clinicopathological indicators and prognosis.Results:In primary breast cancer,the pathological complete response(PCR)rate(20.9%)of the CD68~+TAMs low expression group after neoad-juvant chemotherapy was significantly higher than that of the high expression group,the difference was statistically significant(P=0.047);There was no statistical difference between CD163~+TAMs and PCR(P=0.184),while the CD163~+TAMs low expression group had a significant pathological response(Good pathological response,GPR)ratio(33.3%)than the high expression group,and the difference between the two was significantly correlated(P=0.014);after chemotherapy,the CD68~+and CD163~+TAMs with low expression group reached a higher PCR rate of 100%(9/9),the difference was statistically significant(P=0.049);the levels of CD68~+and CD163~+TAMs before neoadjuvant chemotherapy were not statistically significant with PCR(P>0.05).After chemotherapy,the PCR rate of patients in the CD68~+TAMs decreased group was significantly higher than that in the non-decreased group(35.7%),and the difference was statistically significant(P=0.037);the trend of CD163~+TAMs infiltration was not correlated with PCR(P>0.05).In meta-static lymph nodes,the levels of CD68~+and CD163~+TAMs before and after neoadjuvant chemotherapy were not statistically significant with PCR(P>0.05);the trend of changes in CD68~+and CD163~+TAMs after chem-otherapy was not statistically different from PCR(P>0.05).Before neoa-djuvant chemotherapy,the degree of CD68~+and CD163~+TAMs infiltration in the primary tumor was not correlated with the patient’s age,tumor diameter,TNM stage and Ki-67 expression(all P>0.05).The expression of CD163~+TAMs was statistically significant with the presence or absence of recurrence and metastasis(P=0.044).The univariate survival analysis of log-rank test showed that the expression of CD68~+and CD163~+TAMs had nothing to do with disease-free survival(DFS)and overall survival(Overall Survival)(P>0.05).Conclusions:1.The low expression of CD68~+and CD163~+TAMs in the primary tumor of TNBC after neoadjuvant chemotherapy of TNBC suggests that they are more sen-sitive to chemotherapy.Patients in the group with decreased CD68~+TAMs are more likely to achieve PCR;when CD68~+and CD163~+TAMs are simul-taneously low expressed,the PCR rate is higher.2.The expression of CD163~+TAMs in the primary tumor of TNBC before neoad-juvant chemotherapy of TNBC is statistically significant with the existence of recurrence and metastasis.Survival analysis showed that the expression of CD68~+and CD163~+TAMs in primary tumors before chemotherapy had no-thing to do with DFS and OS.