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The Association of Immune Cell Infiltration with Metastasis Location in De Novo Metastatic Triple Negative Breast Cancer: A Multicenter Cross-Sectional Study in Indonesia

ACTA MEDICA INDONESIANA · Vol. 55 No. 4 (2024)

ISSN
2338-2732, 0125-9326
Terbit
2024-01-12
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng

Abstrak

Background: Triple-negative breast cancer (TNBC) is an aggressive cancer subtype, with limited treatments and a high metastasis risk. The varying location of metastasis in TNBC patients often leads to in prognosis in breast cancer. Therefore, this study aimed to investigate the potential association between immune cells profiles in the tumor microenvironment and metastatic patterns. Methods: We conducted a multicenter cross-sectional study in 2022 to examine formalin-fixed paraffin-embedded (FFPE) and medical record data from 2015 to 2020 in de novo metastatic TNBC patients. The medical records provided crucial information about the sites of metastasis. Immunohistochemistry (IHC) analysis was carried out on primary breast tumor tissues to evaluate the expressions of cluster of differentiation (CD)4 T-cells, CD8 T-cells, CD163, FOXP3 Tregs, and programmed death-ligand 1 (PD-L1), along with immune cells ratios showing antitumor-to-protumor activity (CD4/FOXP3, CD8/FOXP3, CD4/CD163, CD8/CD163). Metastatic locations were grouped into bone-only, visceral, lung, liver, and brain metastasis. Results: A total of 120 metastatic TNBC patients were documented for their metastatic location and IHC report. The clinical and histopathological characteristics showed that the majority of the patients were within the 40-65 years old group, and 34.2% had standard body mass index (BMI). Furthermore, the majority (89.22%) of the patients showed No Special Type (NST), (56.7%) had histopathology grade III, high Ki-67 ≥20% (85.8%), and positive PD-L1 expression (30.8%), with visceral metastasis indicating the highest proportion of 75.8%. Patients with a high CD8/FOXP3 and CD4/FOXP3 ratio were significantly prone to have bone-only metastasis compared to visceral metastasis (p= 0.028 and p=0.024, respectively). Conclusion: The ratio of antitumor to protumor T-lymphocytes had a significant relevance in the metastatic location patterns in TNBC.

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  • University of Indonesia
  • Universitas Teknologi Sumbawa
  • Universitas Halu Oleo
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  • Organisasi berbeda
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Rekan penulisOrganisasiArtikel bersama
Eka GinanjarAfiliasi tidak diketahui4
Lugyanti SukrismanAfiliasi tidak diketahui3
Sally Aman NasutionAfiliasi tidak diketahui3
Pradana SoewondoAfiliasi tidak diketahui3
Simon SalimAfiliasi tidak diketahui3
Kuntjoro HarimurtiAfiliasi tidak diketahui2
Ikhwan RinaldiAfiliasi tidak diketahui2
Em YunirUniversity of Indonesia2
Tri Juli Edi TariganUniversity of Indonesia2
Marlinda AdhamAfiliasi tidak diketahui2
Cosphiadi IrawanAfiliasi tidak diketahui2
Rahmat CahyanurAfiliasi tidak diketahui2
Evy YunihastutiAfiliasi tidak diketahui2
Nurul Inayah RahmaniAfiliasi tidak diketahui2
Rudy HidayatAfiliasi tidak diketahui2
Purwita Wijaya LaksmiAfiliasi tidak diketahui2
Dyah PurnamasariAfiliasi tidak diketahui2
Murdani AbdullahAfiliasi tidak diketahui2
Radiyati Umi PartanAfiliasi tidak diketahui2
Robert SintoAfiliasi tidak diketahui2
La Ode Muhammad Harjoni KilowasidAfiliasi tidak diketahui1
Nurhaida NurhaidaAfiliasi tidak diketahui1
Samsu AlamAfiliasi tidak diketahui1
Sarawa SarawaAfiliasi tidak diketahui1
Dodi Priyatmo SilondaeUniversitas Halu Oleo1
Sudarmi Suud BinasarAfiliasi tidak diketahui1
Aru W SudoyoAfiliasi tidak diketahui1
Nata P Hardjo LugitoAfiliasi tidak diketahui1
Andree KurniawanAfiliasi tidak diketahui1
Rizki YaruntradhaniAfiliasi tidak diketahui1

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">The Association of Immune Cell Infiltration with Metastasis Location in De Novo Metastatic  Triple Negative Breast Cancer:  A Multicenter Cross-Sectional Study in Indonesia</dc:title>
	<dc:creator>Tenggara, Jeffry Beta</dc:creator>
	<dc:creator>Rachman, Andhika</dc:creator>
	<dc:creator>Prihartono, Joedo</dc:creator>
	<dc:creator>Lisnawati, Lisnawati</dc:creator>
	<dc:creator>Panigoro, Sonar Soni</dc:creator>
	<dc:creator>Heriyanto, Didik Setyo</dc:creator>
	<dc:creator>Steven, Ricci</dc:creator>
	<dc:creator>Tandarto, Kevin</dc:creator>
	<dc:creator>Juanputra, Samuel</dc:creator>
	<dc:creator>Sudoyo, Aru Wisaksono</dc:creator>
	<dc:subject xml:lang="en-US">antitumor</dc:subject>
	<dc:subject xml:lang="en-US">immune cells</dc:subject>
	<dc:subject xml:lang="en-US">metastatic location</dc:subject>
	<dc:subject xml:lang="en-US">protumor</dc:subject>
	<dc:subject xml:lang="en-US">triple-negative breast cancer</dc:subject>
	<dc:description xml:lang="en-US">Background: Triple-negative breast cancer (TNBC) is an aggressive cancer subtype, with limited treatments and a high metastasis risk. The varying location of metastasis in TNBC patients often leads to in prognosis in breast cancer. Therefore, this study aimed to investigate the potential association between immune cells profiles in the tumor microenvironment and metastatic patterns. Methods: We conducted a multicenter cross-sectional study in 2022 to examine formalin-fixed paraffin-embedded (FFPE) and medical record data from 2015 to 2020 in de novo metastatic TNBC patients. The medical records provided crucial information about the sites of metastasis. Immunohistochemistry (IHC) analysis was carried out on primary breast tumor tissues to evaluate the expressions of cluster of differentiation (CD)4 T-cells, CD8 T-cells, CD163, FOXP3 Tregs, and programmed death-ligand 1 (PD-L1), along with immune cells ratios showing antitumor-to-protumor activity (CD4/FOXP3, CD8/FOXP3, CD4/CD163, CD8/CD163). Metastatic locations were grouped into bone-only, visceral, lung, liver, and brain metastasis.  Results: A total of 120 metastatic TNBC patients were documented for their metastatic location and IHC report. The clinical and histopathological characteristics showed that the majority of the patients were within the 40-65 years old group, and 34.2% had standard body mass index (BMI). Furthermore, the majority (89.22%) of the patients showed No Special Type (NST), (56.7%) had histopathology grade III, high Ki-67 ≥20% (85.8%), and positive PD-L1 expression (30.8%), with visceral metastasis indicating the highest proportion of 75.8%. Patients with a high CD8/FOXP3 and CD4/FOXP3 ratio were significantly prone to have bone-only metastasis compared to visceral metastasis (p= 0.028 and p=0.024, respectively).  Conclusion: The ratio of antitumor to protumor T-lymphocytes had a significant relevance in the metastatic location patterns in TNBC.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2024-01-12</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2522</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 55 No. 4 (2023): Acta Medica Indonesiana; 376</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2522/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2024 Jeffry Beta Tenggara, Andhika Rachman, Joedo Prihartono, Lisnawati Lisnawati, Sonar Soni Panigoro, Didik Setyo Heriyanto, Ricci Steven, Kevin Tandarto, Samuel Juanputra, Aru Wisaksono Sudoyo</dc:rights>
</oai_dc:dc>