ПРОГНОСТИЧНЕ ЗНАЧЕННЯ ПУХЛИНОАСОЦІЙОВАНИХ МАКРОФАГІВ У ВИЖИВАННІ ПАЦІЄНТІВ ІЗ МЕТАСТАТИЧНИМ HER2-ПОЗИТИВНИМ РАКОМ МОЛОЧНОЇ ЗАЛОЗИ

Recent studies indicate an essential role of the tumor microenvironment in the effectiveness of therapy and survival of patients with various types of cancers, including HER2-positive breast cancer. Tumor-associated macrophages are one of the most common immune cells of the tumor microenvironment, with both pro-tumorogenic and anti-tumorogenic properties.The aim of our study was to clarify the prognostic role of M1 (CD68+) and M2 (CD163+) macrophages in patients with metastatic HER2-positive breast cancer.Material and methods. We studied the tumor tissue of 78 patients with metastatic HER2-positive breast cancer. Tumor tissue samples underwent immunohistochemical examination with antibodies to CD68+ and CD163+ to determine the phenotype of M1 and M2 macrophages, respectively. Data on category T, category N and methods of drug therapy were obtained from primary medical records. Kaplan-Meier method, Cox regression analysis, and log-rank test were used for statistical analysis.Results. The average duration of the follow-up period before registration of disease progression was 21.3±2.79 months. Median progression-free survival was 14.3 months and 13.2 months for patients with high and low CD68+ expression, respectively (Log-rank p=0.6168), and 14.9 months and 12.6 months for patients with low and high expression of CD163+, respectively (Log-rank p=0.0003). Follow-up of patients until death continued for an average of 35.0±2.98 months. Median overall survival was 24.1 months and 29.0 months for patients with high and low CD68+ expression, respectively (Log-rank p=0.5788), and 36.7 months and 22.0 months for patients with low and high expression of CD163+, respectively (Log-rank p=0.0001). Patients receiving a combination of trastuzumab with chemotherapy, without regional lymph node metastases, with low expression of CD163+, and those with hormone-positive HER2-positive breast cancer used hormone therapy have better overall survival.Conclusions. High CD163+ expression is a predictor of poor progression-free survival and overall survival in patients with metastatic HER2-positive breast cancer. CD68+ expression did not show prognostic significance.