Distribution characteristics of CTLA-4 on the surface of CD4+T cells in breast cancer patients with different stages and its prediction of the efficacy of radical mastectomy
10.3781/j.issn.1000-7431.2025.2406-0369
- VernacularTitle:不同分期乳腺癌患者CD4+T细胞表面CTLA-4分布特点及其对根治术疗效的预测
- Author:
Mengxiao WANG
1
;
Xi CHENG
1
;
Yang XIE
1
;
Yaping LI
1
;
Guanggang ZHANG
1
Author Information
1. 重庆市人民医院综合外科,重庆 400013
- Publication Type:Journal Article
- Keywords:
Breast cancer;
CTLA-4;
Pathological staging;
Prognosis
- From:
Tumor
2025;45(3):254-268
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the distribution characteristics of CTLA-4 on the surface of CD4+T cells in patients with breast cancer at different stages,and to evaluate its predictive value for the efficacy of radical mastectomy.Methods:A retrospective study was conducted on 200 breast cancer patients admitted between January 2020 and December 2022.Patients were divided into four groups based on clinical staging:stage Ⅰ(64 cases),stage Ⅱ(57 cases),stage Ⅲ(43 cases),and stage Ⅳ(36 cases).The clinical pathological characteristics of the four groups were compared,and the expression level of CTLA-4 on the surface of CD4+T cells in peripheral venous blood(CTLA-4+CD4+)was detected.Patients were divided into a poor prognosis group(52 cases)and a good prognosis group(148 cases)based on their prognosis,and the clinical pathological characteristics of the two groups were compared.A stratified regression model was used to analyze the relationship between CTLA-4+CD4+expression levels and different clinical characteristics.Logistic regression analysis was employed to evaluate the independent correlation between CTLA-4+CD4+expression levels and the risk of poor prognosis.An unconditional logistic regression model was used to analyze the multiplicative interaction effect of CTLA-4+CD4+expression levels and clinical staging on prognosis prediction.Restricted cubic spline analysis was used to investigate the relationship between CTLA-4+CD4+expression levels and poor patient prognosis.Results:Significant differences were observed in tumor diameter,ECOG score,lesion multiplicity,lymph node metastasis,tumor differentiation degree,ER,PR,HER2,Ki-67,CA125,CA153,and CEA among patients with different clinical stages(P<0.05).Significant differences were also observed in CD3+,CD4+,CD8+,and CTLA-4+CD4+(P<0.05).As the clinical stage increased,the proportions of CD3+,CD4+,and CD8+decreased,while the proportion of CTLA-4 on the surface of CD4+T cells increased(P<0.05).Significant differences were observed in clinical stage,tumor diameter,lymph node metastasis,tumor differentiation degree,ECOG score,ER,PR,HER2,and CTLA-4+CD4+among patients with different prognosis groups(P<0.05).Hierarchical regression analysis indicated that clinical stage,tumor diameter,lymph node metastasis,tumor differentiation degree,ECOG score,and HER2 had a significant positive impact on CTLA-4+CD4+(P<0.05),while ER and PR had a significant negative impact on CTLA-4+CD4+(P<0.05).Logistic regression analysis showed that CTLA-4+CD4+was positively correlated with poor prognosis(P<0.05).CTLA-4+CD4+and clinical stage had multiplicative and additive interactions on prognosis.Regardless of the clinical stage,CTLA-4+CD4+on the surface of CD4+T cells was significantly positively correlated with poor prognosis.Conclusion:The expression level of CTLA-4+CD4+in patients with advanced breast cancer is significantly elevated,playing a crucial role in the clinical pathological characteristics of breast cancer.An elevated level may indicate a poor prognosis.
