Disparity in Tumor Immune Microenvironment of Breast Cancer and Prognostic Impact: Asian Versus Western Populations

The oncologist

article

Ching-Hsuan Chen¹  Tzu-Pin Lu¹  Ching-Hung Lin³  Yen-Shen Lu³  Ann-Lii Cheng³  Chiun-Sheng Huang⁶  Wen-Hung Kuo⁶  Ming-Yang Wang⁶  Ming Chao⁷  I-Chun Chen³  Chun-Wei Kuo⁸ 

[1] Institute of Epidemiology and Preventive Medicine, Department of Public Health, National Taiwan University;Department of Obstetrics and Gynecology, Taipei City Hospital Heping Fuyou Branch;Department of Oncology, National Taiwan University Hospital;Department of Internal Medicine, National Taiwan University Hospital;National Taiwan University Cancer Center;Department of Surgery, National Taiwan University Hospital;Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch;Department of Pathology, National Taiwan University Hospital Hsin-Chu Branch

关键词: Immune cell;    Composition;    Breast cancer;    Asia;    Prognosis;   

DOI  :  10.1634/theoncologist.2019-0123

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background The clinicopathological features and prognosis of breast cancer in Asia are different from those in the Western countries. Tumor-infiltrating immune cells can influence the outcome of patients with breast cancer, but they have not been systemically evaluated in Asian patients with breast cancer. Methods We compared the immune score, composition, and prognostic impact of infiltrating immune cells between Asian and Western patients with breast cancer by analyzing gene expression profiles from eight Gene Expression Omnibus data sets and The Cancer Genome Atlas data set. The Estimation of Stromal and Immune Cells in Malignant Tumours Using Expression Data (ESTIMATE) and Cell Type Identification by Estimating Relative Subsets of Known RNA Transcripts (CIBERSORT) algorithms were used to determine the immune score and composition of tumor-infiltrating immune cells, respectively. Findings This study included 462 Asian patients and 2,186 Western patients. Tumors of Asian patients had significantly higher immune score, particularly in the luminal B and HER2-enriched subtypes. High immune score was associated with favorable prognosis in both Asian and Western patients, and Asian race with a high ESTIMATE immune score provided additional power to predict longer disease-free survival. Activated CD4 T cells and M2 macrophages were the most strongly associated with survival in both Asian and Western patients. Interpretation Our study highlights the difference in tumor immune microenvironments between Asian and Western patients. The higher ESTIMATE immune score, which represents more abundant tumor-infiltrating immune cells, in tumors of Asian patients partly explains their favorable prognosis. Implications for Practice The tumor microenvironment serves as an interface that affects the human body's reaction to cancer cells. Evidence has revealed that tumor-infiltrating immune cells were associated with patient prognosis. This study demonstrated the disparity of tumor microenvironments and their prognostic impact between Asian and Western patients with breast cancer. The differences in immune score partially explained the racial survival differences noted in recent studies. Integrated analysis of tumor cells, tumor microenvironment, and racial effect may significantly improve recurrence risk prediction for patients with stage I–III breast cancer. Because the effect of tumor microenvironment varies across different populations, a model of interaction between immune score and race/ethnicity is recommended in accessing the risk of patients with cancer.

【 授权许可】

CC BY|CC BY-NC