Peripheral blood immune markers in breast cancer: Differences in regulatory T cell abundance are related to clinical parameters

Background: Cancer development is among other factors driven by tumor immune escape and tumor-mediated changes in the immune response. Investigating systemic immune changes may provide important knowledge for the improvement of patient prognosis and treatment opportunities. Methods: The systemic immune profile of patients with ER-positive breast cancer (n = 22) and healthy controls (n = 30) was investigated based on complete blood counts, flow cytometric analysis of T cell subsets including regulatory T cells (Tregs), and immune assays investigating soluble (s)HLA-G and the cytokine profile in plasma. We further examined the correlation between the immune markers and clinical parameters including tumor size, tumor grade and lymph node involvement. Results: Results indicated that breast cancer patients possessed a higher amount of neutrophils and monocytes and fewer lymphocytes and eosinophils compared with healthy controls. Breast cancer patients had significantly more CD25(+)CD127(low) Tregs than controls, and both lymphocyte and Treg numbers were negatively correlated with tumor size. Furthermore, Treg numbers were elevated in grade I tumors compared with grade II tumors and with healthy controls. No difference in sHLA-G levels was observed between patients and controls. Higher levels of IL-6 and TNF-alpha were observed in breast cancer patients. Cytokine and sHLA-G levels were not associated with clinical parameters. Conclusion: The results of this exploratory study contribute to the elucidation of the systemic immune response in breast cancer indicating a potential use of peripheral immune cell counts and Tregs to distinguish patients from healthy controls and as potential diagnostic and prognostic biomarkers to be investigated in future studies.

Automated summary

This study investigated systemic immune changes in ER-positive breast cancer patients and healthy controls, finding higher levels of neutrophils and monocytes, lower levels of lymphocytes and eosinophils in patients. CD25(+)CD127(low) Tregs were increased in patients and correlated with tumor size. Tumor grade also affected Treg numbers. The results suggest potential diagnostic and prognostic biomarkers in peripheral immune cell counts and Tregs.