Quantitative and spatial distribution characteristics of CD66b+ tumor-associated neutrophils in metaplastic and non-metaplastic triple-negative breast cancer treated with neoadjuvant therapy and their prognostic significance

Comprehensive Summary

Cases of patients with metaplastic and non-metaplastic triple negative breast cancer (MpBC and TNBC) were retroactively analyzed. An AI-based positive cell classifier aided in the determination that CD66+ TAN is a potential prognostic biomarker in MpBC and non-metaplastic TNBC patients. All patients within the study were treated with neoadjuvant chemotherapy (NACT). The cell classifier quantified and spatially mapped CD66+ TANs within the cases, which were then compared via clinicopathological characteristics. It was discovered that MpBC and TNBC patients displayed significant disparities in age, tumor size, Ki-67 expression, residual cancer burden grade, pathologic complete remission (pCR) rate, disease-free survival (DFS), CD66+ TAN density, and spatial distribution. The study deduced that larger tumor size and stromal-predominant CD66+ TAN distribution were associated with poorer prognosis in MpBC patients. In TNBC patients, with tumor size greater than 2 cm, androgen receptor positivity, and high CD66+ TAN density, poor pCR rates were realized. Additionally, tumor size above 2 cm linked with lymph node positivity and elevated CD66+ TAN density was linked to poor DFS. No MpBC patients achieved pCR, but 30.8% of non-metaplastic TNBC patients did. In conclusion, CD66+ TAN density and distribution, as identified by an AI-based positive cell classification system, displays clear evidence of being related to MpBC and non-metaplastic TNBC patient prognosis.

Outcomes and Implications

AI-identified CD66+ TAN density and distribution displays relation to prognosis in MpBC and non-metaplastic TNBC patients. The utilization of new AI resources in medical research can lead to stronger understanding of the biomarkers which impact MpBC and non-metaplastic TNBC survival rates.