The Role of the Molecular Subtypes in the Prognosis of Breast Cancer Patients

BACKGROUND: Understanding the biology of the tumor, by dividing it into molecular subtypes, has made it possible to individualize the therapeutic approach in high-risk patients. AIM: We aimed to determine the importance of established molecular subtypes in the prognosis and the importance of disease-free and overall survival (OS) in patients with non-metastatic breast cancer. MATERIALS AND METHODS: We analyzed 94 patients with non-metastatic breast cancer for the period 2010–2018. The median follow-up time was 60 months. The mean age in the study group was 60.03 years (SD ± 10.52). According to the characteristics of the studied indicators, we divided the group into Luminal A (n-59 [62.7%]), Luminal B/HER2 (−) (n-2 [2.1%]), Luminal B/HER2 (+) (n-8 [8.5%]), HER2 overexpressing (n-3 [3.2%]), and triple-negative subtype (n-22 [23.5%]). In all patients in the study group, we analyzed the 5-year overall survival (OS) and disease-free survival (DFS) and referred it to molecular subtypes, lymphatic status, HER-2 status, the presence or absence of endocrine therapy for the follow-up period, tumor differentiation, and type of surgery. RESULTS: We observed the 5-year OS in 92% of patients identified as Luminal A; at 50% of Luminal B/HER2 (−) neg.; in 62.5% with Luminal B/HER2 (+), in 67% with HER2-overexpressing carcinoma; and in 66.7% of patients with triple-negative subtype. The total cancer-associated mortality rate in the analyzed period reached 15.9% (n = 15). Patients with mastectomy (p = 0.019, p = 0.027), positive axilla with more than 4 lymph node (LN) (p = 0.000; p = 0.000), and Luminal B/HER-2 (+) tumors (p = 0.004; p = 0.003) were the independent prognostic factors for worse DFS and OS in our study group. Histological differentiation and HER-2 expression were in unsatisfactory correlation (p = 0.077; p = 0.044 and p = 0.081; p = 0.055, respectively). CONCLUSION: Molecular subtypes are essential in the prognosis of breast cancer and maybe a criterion for an individualized therapeutic approach

Intratumoural expression of IL-6/STAT3, IL-17 and FOXP3 immune cells in the immunosuppressive tumour microenvironment of colorectal cancer Immune cells-positive for IL-6, STAT3, IL-17 and FOXP3 and colorectal cancer development

AbstractImmune cells in the tumour microenvironment (TME) interact with each other and with tumour cells to promote tumour development. IL-6/STAT3 pathway induces and maintains mainly pro-tumour TME. Macrophages and lymphocytes are positive for IL-6, STAT3 and IL-17, while FoxP3 cells are mainly regulatory cells. IL-17+ and FoxP3+ immune cells have impact on gut inflammation and tumourigenesis. The aim of this study was to determine IL-6+, STAT3+, IL-17+ and FoxP3+ immune cells in colorectal cancer (CRC) TME and explore their association with clinicopathological parameters and mismatch repair (MMR) status. The investigated samples were collected from 104 CRC patients. Immunohistochemistry for the aforementioned markers and microsatellite instability (MSI) markers was performed. MSI testing was used. The investigated immune cells were significantly more in the invasive front (IF) as compared to tumour stroma (TS). IL-6+ and STAT3+ immune cells were more in the early tumour stages as compared to advanced stages. IL-17+ and IL-6+ immune cells were more in well and moderately differentiated cancers. IL-6+, STAT3+ and IL-17+ immune cells prevailed in the TME in microsatellite stable patients and only FoxP3+ cells were fewer there. Higher numbers of STAT3+ cells correlated with longer survival. These results support the suggestion that the transition of normal colonic mucosa to CRC is marked by a shift of Th programme, leading to accumulation of Th17 cells and Tregs that sustain tumour cell growth through the IL-6/STAT3 signalling pathway