Aim of the study
Although early diagnosis of breast cancer (BC) is often associated with a good prognosis, there is currently no biomarker with high sensitivity serving this purpose. B7H3, a recently identified member of the B7 family, appears to inhibit antitumor immunity. We investigated the soluble B7H3 (sB7H3) level in BC and its relationship with clinicopathological variables and stromal tumor-infiltrating lymphocytes (sTILs).
Material and methods
The study, which was designed as a cross-sectional trial between January 2020 and September 2021, included 93 BC patients, 20 patients with benign breast disease (BBD) and 14 healthy volunteers as the control group. Serum sB7H3 levels were measured using the ELISA (enzyme-linked immunosorbent assay) method and sTILs were measured by immunohistochemistry using Tru-cut biopsy materials.
Results
sB7H3 levels in BC patients were significantly higher than those in patients with BBD and healthy volunteers. Receiver operating characteristic curve analysis results showed that sB7H3 level may be a potential biomarker for distinguishing patients with BC from those with BBD (AUC: 0.807; sensitivity: 0.786; specificity: 0.706) and from healthy volunteers (AUC: 0.731; sensitivity: 0.700; specificity: 0.692).
Conclusions
To the best of our knowledge, the present study is the first to investigate the relationship between sB7H3 and disease parameters in BC. We found that sB7H3 may be a clinically practical and meaningful biomarker in differentiating BC from BBD. In order to evaluate the relationship of B7H3 with clinical variables in BC, and especially with sTILs, tissue-based studies with higher numbers of patients are needed.
Sentinel lymph node dissection (SLND) is a reliable method that provides axillary staging in clinical node-negative (cN0) breast cancer patients before neoadjuvant chemotherapy (NACT). However, it is not a standard method on its own due to the high false-negative rates (FNR) reported in initially clinical node-positive patients (cN1-cN3). The contribution of magnetic resonance imaging (MRI) to SLND after chemotherapy is not well understood. In our study, we aimed to investigate the contribution of post-NACT MRI to SLND in breast cancer patients receiving NACT. Between January 2014 and December 2020, patients who had MRI images including the axilla after NACT and had axillary lymph nodes evaluation performed simultaneously with SLND were included in the study. MRI images of all patients were re-evaluated by 2 experienced clinicians. MRI and SLND results were analyzed to detect axillary lymph node metastasis. 117 patients were included in the study. The median age of the patients was 49 years. Before chemotherapy, 108 patients (92.3%) had tumor metastases in their axilla pathologically confirmed by tru-cut biopsy. Axillary downstage was obtained in 48.1% (n=52) of the patients after NACT. Of the 56 patients with axillary node positivity, 3 patients had no metastasis in the SLND evaluation (FNR=5.4%). The sensitivity of post-NACT MRI in detecting node positivity was 69.6%, the specificity was 90.2%, the positive predictive value (PPV) was 86.7% and the negative predictive value (NPV) was 76.4. SLND together with MRI predicted all node-positive patients (FNR=0%). In summary, SLND may not detect a group of patients with residual axillary lymph node metastases after NACT. We have shown that MRI can contribute to identifying these patients. If no metastases are detected by both methods (SLND and MRI), avoidance of axillary dissection may be an acceptable choice.
Küçük Hücreli akciğer kanseri (KHAK) kemoterapiye duyarlı ancak kötü prognozu olan bir akciğer kanseri türüdür. Bu çalışmamızda lenfosit/monosit oranının ile birlikte diğer klinik ve laboratuvar parametrelerinin prognostik önemini araştırmayı amaçladık. Araçlar ve Yöntem: Bu çalışmamızda retrospektif olarak Ocak 2014 ile Aralık 2019 tarihleri arasında KHAK tanısı almış ve yaygın evrede olan 146 hastanın tıbbi kayıtları incelendi. Kemoterapi öncesi alınan kan tetkiklerinden lenfosit/monosit oranı (LMO) hesaplandı. Bulgular: Çalışmaya alınan hastalarda medyan genel sağ kalım süresi 8.78 (aralık 1.07-54.80) ay, progresyonsuz sağ kalım süresi (PSK) 5.6 (1.07-44.03) ay olarak bulundu. Tüm hastaların kohort analizinde, LMO düşük grupta medyan PSK 4.5 ay, genel sağ kalım süresi (GSK) 7.5 ay olup, LMO yüksek grupta medyan PSK 6.5 ay, GSK 10.1 ay olarak saptandı. Tek değişkenli analiz ile incelendiğinde LMO yüksek olan hastaların düşük olan hastalara göre genel sağ kalım süreleri de daha uzundu (HR 0.591 %95 CI 0.42-0.83 p=0.003). Çok değişkenli analiz ile incelendiğinde ise LMO yüksekliği sağ kalım için iyi prognostik göstergelerden biri olma özelliğini devam ettiriyordu (HR: 0.54 %95 CI 0.38-0.77. p=0.001) Sonuç: Yüksek LMO, yaygın evre küçük hücreli akciğer kanseri hastalarında uzun PSK ve GSK'yı gösteren bağımsız bir prognostik parametre olabileceği kanıtlandı.
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