Breast Cancer Survival Outcomes and Tumor-Associated Macrophage Markers: A Systematic Review and Meta-Analysis

被引:32
作者
Allison, Eleanor [1 ]
Edirimanne, Senarath [1 ]
Matthews, Jim [2 ]
Fuller, Stephen J. [1 ]
机构
[1] Univ Sydney, Sydney Med Sch, Nepean Clin Sch, Level 3,62 Derby St, Kingswood, NSW 2747, Australia
[2] Univ Sydney, Sydney Informat Hub, Camperdown, NSW 2006, Australia
关键词
Breast cancer; Tumor-associated macrophage; CD68; CD163; Prognosis; Triple-negative breast cancer; EPITHELIAL-MESENCHYMAL TRANSITION; POOR-PROGNOSIS; INFILTRATING MACROPHAGES; PROLIFERATIVE ACTIVITY; SCAVENGER RECEPTOR; CELL; EXPRESSION; DENSITY; PROGRESSION; RECURRENCE;
D O I
10.1007/s40487-022-00214-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction Tumor-associated macrophages (TAMs) in breast cancer are associated with a poor prognosis. Early studies of TAMs were largely limited to the pan-macrophage marker CD68, however, more recently, an increasing number of studies have used CD163, a marker expressed by alternatively activated M2 macrophages and TAM subsets. We hypothesized that CD163-positive (CD163+) TAMs would be a better predictor of survival outcomes in breast cancer compared to CD68+ TAMs. Methods We performed a systematic literature search of trials (from 1900 to August 2020) reporting overall survival (OS) or progression-free survival (PFS), breast cancer-specific survival (BCSS), TAM phenotype, and density. Thirty-two studies with 8446 patients were included. Meta-analyses were carried out on hazard ratios (HRs) for survival outcomes of breast cancer patients with a high density of TAMs (CD68+ and/or CD163+) compared to a low density of TAMs. Results A high density of TAMs (CD68+ and/or CD163+) was associated with decreased OS (HR 1.69, 95% CI 1.37-2.07) and reduced PFS (HR 1.64; 95% CI 1.35-1.99). Subgrouping by CD marker type showed a lower OS for high density of CD163+ TAMs (HR 2.24; 95% CI 1.71-2.92) compared to a high density of CD68+ TAMs (HR 1.5; 95% CI 1.12-2). A high density of TAMs (CD68+ and/or CD163+) in triple-negative breast cancer (TNBC) cases was associated with lower OS (HR 2.81, 95% CI 1.35-5.84). Conclusion Compared to CD68+ TAMs, a high density of CD163+ TAMs that express a similar phenotype to M2 macrophages are a better predictor of poor survival outcomes in breast cancer.
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页码:27 / 48
页数:22
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