Spatial Metrics of Interaction between CD163-Positive Macrophages and Cancer Cells and Progression-Free Survival in Chemo-Treated Breast Cancer

Brenton A Maisel; Misung Yi; Amy R Peck; Yunguang Sun; Jeffrey A Hooke; Albert J Kovatich; Craig D Shriver; Hai Hu; Marja T Nevalainen; Takemi Tanaka; Nicole Simone; Li Lily Wang; Hallgeir Rui; Inna Chervoneva

doi:10.3390/cancers14020308

Spatial Metrics of Interaction between CD163-Positive Macrophages and Cancer Cells and Progression-Free Survival in Chemo-Treated Breast Cancer

Cancers (Basel). 2022 Jan 8;14(2):308. doi: 10.3390/cancers14020308.

Authors

Affiliations

¹ Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA.
² Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
³ John P. Murtha Cancer Center, Uniformed Services University and Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.
⁴ Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA 15963, USA.
⁵ Department of Pathology, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK 73104, USA.
⁶ Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
⁷ Department of Translational Hematology and Oncology Research, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Abstract

Tumor-associated macrophages (TAMs) promote progression of breast cancer and other solid malignancies via immunosuppressive, pro-angiogenic and pro-metastatic effects. Tumor-promoting TAMs tend to express M2-like macrophage markers, including CD163. Histopathological assessments suggest that the density of CD163-positive TAMs within the tumor microenvironment is associated with reduced efficacy of chemotherapy and unfavorable prognosis. However, previous analyses have required research-oriented pathologists to visually enumerate CD163+ TAMs, which is both laborious and subjective and hampers clinical implementation. Objective, operator-independent image analysis methods to quantify TAM-associated information are needed. In addition, since M2-like TAMs exert local effects on cancer cells through direct juxtacrine cell-to-cell interactions, paracrine signaling, and metabolic factors, we hypothesized that spatial metrics of adjacency of M2-like TAMs to breast cancer cells will have further information value. Immunofluorescence histo-cytometry of CD163+ TAMs was performed retrospectively on tumor microarrays of 443 cases of invasive breast cancer from patients who subsequently received adjuvant chemotherapy. An objective and automated algorithm was developed to phenotype CD163+ TAMs and calculate their density within the tumor stroma and derive several spatial metrics of interaction with cancer cells. Shorter progression-free survival was associated with a high density of CD163+ TAMs, shorter median cancer-to-CD163+ nearest neighbor distance, and a high number of either directly adjacent CD163+ TAMs (within juxtacrine proximity <12 μm to cancer cells) or communicating CD163+ TAMs (within paracrine communication distance <250 μm to cancer cells) after multivariable adjustment for clinical and pathological risk factors and correction for optimistic bias due to dichotomization.

Keywords: breast cancer; cancer biomarkers; marked point patterns; microscopic image analysis; nearest neighbor distance; quantitative pathology; spatial interactions; spatially-resolved immunohistochemistry data; tumor immune microenvironment; tumor-associated macrophages.

Abstract

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