The Role of Tumor-Associated Macrophage Density to Tumor Size and Lymph Node Metastases of Invasive Ductal Carcinoma Patients at Dr. Soedarso General Hospital Pontianak
Abstract
Background: Invasive ductal carcinoma is the most common form of breast cancer worldwide and has a high mortality rate. The main component of the innate immune system in the tumor environment is the tumor-associated macrophage (TAM). Certain types of TAM are known to affect tumor size and lymph node metastasis which makes the cancer prognosis worse. Currently, TAM identification is generally identified using immunohistochemical staining techniques that require high costs and special expertise. An easy and inexpensive TAM identification technique is needed in determining breast cancer prognostic factors. This study focused on TAM density and its role in tumor size and lymph node metastases of invasive ductal carcinoma patients.
Methods: This research is an observational analytic study using a cross-sectional approach. This study was conducted by observing the Hematoxylin-Eosin (HE) preparation of invasive ductal carcinoma patients. This study used 55 medical record data and histopathology laboratory reports of invasive ductal carcinoma patients at Dr. Soedarso General Hospital Pathological Anatomy Laboratory. TAM density cut-off is measured by calculating the median data of TAM density. Research analysis was performed using Spearman’s rho correlation test in SPSS version 24.
Results: The cut-off value for determining TAM density obtained from observations based on the average value was 29. The highest number of tumor size groups was T4, and the highest number of lymph node metastases was N2. TAM density was significantly not correlated to tumor size (p = 0.285, p > 0.05) and lymph node metastases (p = 0.479, p > 0.05)
Conclusions: This study found no significant correlation between TAM density, assessed through a cost-effective method using HE staining, and tumor size or lymph node metastasis in invasive ductal carcinoma patients.
Keywords
DOI: 10.33371/ijoc.v18i4.1161
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References
World Health Organisation. Cancer [Internet]. [cited 2022 Mar 8]. Available from: https://www.who.int/news-room/fact-sheets/detail/cancer
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209–49.
Dinas Kesehatan Provinsi Kalimantan Barat. Cegah Sejak Dini Kanker Serviks Dan Payudara Melalui Pelatihan Tenaga Kesehatan Puskesmas [Internet]. [cited 2022 May 11]. Available from: https://dinkes.kalbarprov.go.id/cegah-sejak-dini-kanker-serviks-dan-payudara-melalui-pelatihan-tenaga-kesehatan-puskesmas/
World Health Organization International Agency for Research on Cancer (IARC). GLOBOCAN. 2020.
Watkins EJ. Overview of breast cancer. JAAPA. 2019;32:13–7.
Kanavati F, Tsuneki M. Breast Invasive Ductal Carcinoma Classification on Whole Slide Images with Weakly-Supervised and Transfer Learning. Cancers (Basel). 2021;13:5368.
Kementerian Kesehatan Republik Indonesia [Internet]. [cited 2022 Jul 5]. Available from: https://www.kemkes.go.id/article/view/22020400002/kanker-payudara-paling-banyak-di-indonesia-kemenkes-targetkan-pemerataan-layanan-kesehatan.html
Kementerian Kesehatan Republik Indonesia. Pusat Data dan Informasi [Internet]. [cited 2022 Mar 9]. Available from: https://pusdatin.kemkes.go.id/folder/view/01/structure-publikasi-data-pusat-data-dan-informasi.html
Dinas Kesehatan Provinsi Kalimantan Barat. Publikasi Data dan Informasi [Internet]. [cited 2022 Apr 11]. Available from: https://dinkes.kalbarprov.go.id/unduh/publikasi-data-informasi/
Hu Y, He MY, Zhu LF, Yang CC, Zhou ML, Wang Q, et al. Tumor-associated macrophages correlate with the clinicopathological features and poor outcomes via inducing epithelial to mesenchymal transition in oral squamous cell carcinoma. J Exp Clin Cancer Res. 2016 Jan 15;35:12.
Pan Y, Yu Y, Wang X, Zhang T. Tumor Associated Macrophages in Tumor Immunity. Front Immunol. 2020;11.
Munir MT, Kay MK, Kang MH, Rahman MM, Al-Harrasi A, Choudhury M, et al. Tumor-Associated Macrophages as Multifaceted Regulators of Breast Tumor Growth. Int J Mol Sci. 2021;22.
Allison E, Edirimanne S, Matthews J, Fuller SJ. Breast Cancer Survival Outcomes and Tumor-Associated Macrophage Markers: A Systematic Review and Meta-Analysis. Oncol Ther. 2023;11:27–48.
Adi MS. Gambaran Umur, dan Jenis Kelamin Pasien Kanker Payudara di RS Ibnu Sina Kota Makassar Elma Elmika. Jurnal Penelitian Kesehatan “SUARA FORIKES” (Journal of Health Research “Forikes Voice”). 2020;11:1.
Stanisławek A. Breast Cancer—Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies— An Updated Review. 2021;1–30.
Smetana K, Lacina L, Szabo P, Dvoánková B, Broẑ P, Ŝedo A. Ageing as an important risk factor for cancer. Anticancer Res. 2016;36:5009–17.
Nurhasanah B, Kasuba ASFT. Karakteristik Dan Gambaran Klinis Pasien Kanker Payudara Yang Dirawat Inap Di RSUD DR H Chasan Boesri Ternate Tahun 2019. Kierha Medical Journal. 2019;1:38–43.
I Gede Indradika Pratama Putra. Karakteristik Klinikopatologi Penderita Karsinoma Payudara Di Rsup Sanglah Tahun 2013 – 2016. Jurnal Medika UDAYANA. 2019;8.
Watkins EJ. Overview of Breast Cancer. J Am Acad Physician Assist. 2019;32:13–7.
American Joint Committee on Cancer. AJCC Cancer Staging Manual. 5th ed. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. New York: Springer; 2015.
Gnanamuttupulle M, Henke O, Ntundu SH, Serventi F, Mwakipunda LE, Amsi P, et al. Clinicopathological characteristics of breast cancer patients from Northern Tanzania: common aspects of late stage presentation and triple negative breast cancer. Ecancermedicalscience. 2021 Sep 7;15:1282.
He ZY, Wu SG, Yang Q, Sun JY, Li FY, Lin Q, et al. Breast Cancer Subtype is Associated With Axillary Lymph Node Metastasis. Medicine. 2015;94:e2213.
Guan X, Xu G, Shi A, Zou Y, Zhan Y, Fan Z, et al. Comparison of clinicopathological characteristics and prognosis among patients with pure invasive ductal carcinoma, invasive ductal carcinoma coexisted with invasive micropapillary carcinoma, and invasive ductal carcinoma coexisted with ductal carcinoma in situ. Medicine. 2020;99:e23487.
Ni C, Yang L, Xu Q, Yuan H, Wang W, Xia W, et al. CD68- and CD163-positive tumor infiltrating macrophages in non-metastatic breast cancer: a retrospective study and meta-analysis. J Cancer. 2019;10:4463–72.
Gwak JM, Jang MH, Kim D Il, Seo AN, Park SY. Prognostic Value of Tumor-Associated Macrophages According to Histologic Locations and Hormone Receptor Status in Breast Cancer. PLoS One. 2015;10:e0125728.
Tiainen S, Tumelius R, Rilla K, Hämäläinen K, Tammi M, Tammi R, et al. High numbers of macrophages, especially M2-like (CD163-positive), correlate with hyaluronan accumulation and poor outcome in breast cancer. Histopathology. 2015;66:873–83.
Yuan Z-Y, Luo R-Z, Peng R-J, Wang S-S, Xue C. High infiltration of tumor-associated macrophages in triple-negative breast cancer is associated with a higher risk of distant metastasis. Onco Targets Ther. 2014;1475.
Zhang Y, Cheng S, Zhang M, Zhen L, Pang D, Zhang Q, et al. High-Infiltration of Tumor-Associated Macrophages Predicts Unfavorable Clinical Outcome for Node-Negative Breast Cancer. PLoS One. 2013;8:e76147.
Campbell MJ, Wolf D, Mukhtar RA, Tandon V, Yau C, Au A, et al. The Prognostic Implications of Macrophages Expressing Proliferating Cell Nuclear Antigen in Breast Cancer Depend on Immune Context. PLoS One. 2013;8:e79114.
Lendeckel U, Venz S, Wolke C. Macrophages: shapes and functions. ChemTexts. 2022;8:12.
DeNardo DG, Ruffell B. Macrophages as regulators of tumour immunity and immunotherapy. Nat Rev Immunol. 2019;19:369–82.
Liu J, Geng X, Hou J, Wu G. New insights into M1/M2 macrophages: key modulators in cancer progression. Cancer Cell Int. 2021;21:389.
Larionova I, Tuguzbaeva G, Ponomaryova A, Stakheyeva M, Cherdyntseva N, Pavlov V, et al. Tumor-Associated Macrophages in Human Breast, Colorectal, Lung, Ovarian and Prostate Cancers. Front Oncol. 2020;10:1–34.
Jeong H, Hwang I, Kang SH, Shin HC, Kwon SY. Tumor-Associated Macrophages as Potential Prognostic Biomarkers of Invasive Breast Cancer. J Breast Cancer. 2019;22:38.
Mwafy SE, El-Guindy DM. Pathologic assessment of tumor-associated macrophages and their histologic localization in invasive breast carcinoma. J Egypt Natl Canc Inst. 2020 Jan 27;32(1):6.
Wang H, Tian T, Zhang J. Tumor-Associated Macrophages (TAMs) in Colorectal Cancer (CRC): From Mechanism to Therapy and Prognosis. Int J Mol Sci. 2021 Aug 6;22(16):8470.
Miyasato Y, Shiota T, Ohnishi K, Pan C, Yano H, Horlad H, et al. High density of CD204-positive macrophages predicts worse clinical prognosis in patients with breast cancer. Cancer Sci. 2017 Aug;108(8):1693-1700.
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