Prognostic Influence of Tumor Stroma on Breast Cancer Subtypes

Clin Breast Cancer. 2018 Feb;18(1):e123-e133. doi: 10.1016/j.clbc.2017.08.008. Epub 2017 Aug 19.

Abstract

Introduction: The objective of the present work was to evaluate the impact of the phenotype of both intratumoral mononuclear inflammatory cells (MICs) and cancer-associated fibroblast (CAFs), assessed as to their expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) on prognosis in different breast cancer subtypes.

Materials and methods: A total of 247 tumors of patients with primary ductal invasive breast cancer were categorized into 1 of 4 major subtypes, using the 3 standard immunohistochemical markers (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor/Neu 2 [HER2] receptor status). An immunohistochemical study was performed using tissue arrays and specific antibodies against MMP-9, MMP-11, and MMP-14, and TIMP-1 and TIMP-2.

Results: MMP-11 expression by MICs was significantly and strongly associated with prognosis in all breast cancer subtypes. There were other significant associations with poor prognosis in luminal A tumors: expressions of MMP-9, MMP-11, and TIMP-2 by CAFs, in luminal B tumors: MMP-14 expression by MICs and TIMP-2 expression by MICs, in HER-2-positive tumors: expression of MMP-9 by MICs, and in triple negative breast cancers: expression of TIMP-1 by MICs.

Conclusion: Characterization of both tumor stromal CAFs and MICs, with regard to the expression of MMPs and TIMPs, improve the prognostic evaluation of all breast cancer subtypes.

Keywords: Cancer-associated fibroblasts; Intratumoral inflammatory cells; MMPs; Molecular subtype; TIMPs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Tumor / metabolism*
  • Breast / cytology
  • Breast / pathology
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Cancer-Associated Fibroblasts / pathology*
  • Carcinoma, Ductal, Breast / mortality
  • Carcinoma, Ductal, Breast / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Matrix Metalloproteinase 11 / metabolism
  • Matrix Metalloproteinase 14 / metabolism
  • Matrix Metalloproteinase 9 / metabolism
  • Middle Aged
  • Prognosis
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Survival Analysis
  • Tissue Array Analysis
  • Tissue Inhibitor of Metalloproteinase-1 / metabolism
  • Tissue Inhibitor of Metalloproteinase-2 / metabolism
  • Tumor Microenvironment*

Substances

  • Biomarkers, Tumor
  • Receptors, Estrogen
  • Receptors, Progesterone
  • TIMP1 protein, human
  • TIMP2 protein, human
  • Tissue Inhibitor of Metalloproteinase-1
  • Tissue Inhibitor of Metalloproteinase-2
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • MMP11 protein, human
  • Matrix Metalloproteinase 11
  • MMP9 protein, human
  • Matrix Metalloproteinase 9
  • MMP14 protein, human
  • Matrix Metalloproteinase 14