Cytokine Plasma Levels in Breast Cancer Patients, Before and After Surgery

Studying the levels of cytokines in the plasma of patients could be valuable in guiding immunotherapy policies. We assessed the plasma levels of 4 major cytokines [interferon (IFN)-beta, interleukin-2 (IL-2), tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF-beta)] collected from 19 patients with ductal breast cancer (BCa), before surgery (BS) and 5 days after surgery (AS). The ratio AS/BS was also calculated and correlated with histopathological variables and tumor-infiltrating lymphocyte (TIL) density. The IFN-beta and TNF-alpha levels were significantly higher in BCa patients, BS and AS, than healthy controls (P < 0.02). High IL-2 levels BS were linked with node involvement (P = 0.02), and marginally with HER2 expression (P = 0.08), while high TNF-alpha levels were linked with high PgR expression (P = 0.02). Increasing IFN-beta, IL-2, and TNF-alpha levels were noted AS, which was more evident in patients with larger tumors. The TGF-beta levels were significantly lower in BCa patients (P < 0.007). Linear regression analysis showed a direct association of IFN-beta levels AS (P = 0.02, r = 0.52) and of TNF-alpha AS/BS-ratio (P = 0.001, r = 0.72) with TIL-density. It is suggested that although effector immune response is evident in the majority of early stage BCa patients, removal of the primary tumor further unblocks such responses.