Infiltration by myeloperoxidase-positive neutrophils is an independent prognostic factor in breast cancer

Breast Cancer Res Treat. 2019 Oct;177(3):581-589. doi: 10.1007/s10549-019-05336-3. Epub 2019 Jul 2.

Abstract

Purpose: Myeloperoxidase (MPO) is an enzyme secreted by neutrophil granulocytes as a result of phagocytosis during inflammation. In colorectal cancer, tumour infiltration by MPO expressing cells has been shown to be independently associated with a favourable prognosis. In this study, we explored the role of MPO-positive cell infiltration and its prognostic significance in invasive breast cancer.

Methods: We performed immunohistochemical staining for MPO on multiple tissue microarrays comprising a total of 928 human breast cancer samples with detailed clinical-pathological annotation and outcome data.

Results: MPO-positive cell infiltration (≥ 5 cells/tissue punch) was found in 150 (16%) of the 928 evaluable breast cancer cases. In univariate survival analyses, infiltration by MPO-positive cells was associated with a significantly better overall survival (p < 0.001). In subset univariate analyses, the infiltration by MPO-positive cells was associated with significantly better overall survival in the Luminal B/HER2-negative subtype (p = 0.005), the HER2 enriched subtype (p = 0.011), and the Triple Negative subtype (p < 0.001). In multivariate analysis, MPO expression proved to be an independent prognostic factor for improved overall survival (p < 0.001).

Conclusions: This is the first study to show that infiltration of MPO-positive cells is an independent prognostic biomarker for improved overall survival in human breast cancer.

Keywords: Breast cancer; Myeloperoxidase; Prognostic factor; Tumour-associated neutrophils.

MeSH terms

  • Aged
  • Biomarkers, Tumor
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Neutrophil Infiltration*
  • Neutrophils / enzymology*
  • Neutrophils / pathology*
  • Peroxidase / genetics
  • Peroxidase / metabolism*
  • Prognosis
  • Retrospective Studies

Substances

  • Biomarkers, Tumor
  • Peroxidase