A STUDY OF TUMOR ASSOCIATED MACROPHAGES AND THEIR SUBPOPULATION M1 AND M2 BY IMMUNOHISTOCHEMISTRY IN PRIMARY BREAST CARCINOMA

Abstract

BACKGROUND: One of several major causes of cancer-related deaths in women is breast carcinoma. The macrophage is the primary immune cell present in the tumor microenvironment. They are, therefore, also called tumor-associated macrophages (TAMs). CD68 has a pro-inflammatory and antitumor response. CD163 has an anti-inflammatory response. Collection of intratumoral TAMs correlates with adverse clinical outcomes. Tumor microenvironment targeting helps in reducing tumor burden and improve prognosis. AIMS AND OBJECTIVES: To analyze the density of expression of CD68 TAMs and CD163 TAMs with intratumoral and peritumoral distribution in primary breast carcinoma and study the association of CD68 TAMs and CD163 TAMs with stage and grade of primary breast carcinoma. MATERIALS AND METHODS: This is a laboratory-based exploratory study. Data of 55 primary breast carcinoma cases were included in the study, and cases with metastatic tumors from other sites, recurrent lesions, and patients subjected to chemotherapy and radiotherapy were excluded. H&E slides were reviewed. Immunostaining for CD68 and CD163 was performed. The cases were distributed into low and high groups based on cut-off points according to the median. P-value of <0.05 considered statistically significant. RESULTS: The study demonstrated that the density of CD68 macrophages in the peritumoral area increases as the pathological stage increases and the density of CD68 macrophages in the intratumoral area decreases as the tumor grade increases and is statistically significant (p<0.05). Cancer tissue showed higher CD163 TAMs density than those in normal tissues, but the correlation with pathological stage, grade, and lymph node metastasis is not significant. CONCLUSION: The density of CD68 macrophages in the peritumoral area increases as the pathological stage increases, and the density of expression of CD68 macrophages in the intratumoral area decreases as the grade of tumor increases. A high density of CD68 macrophages was seen in the peritumoral area if lymph node metastasis is present in the study. A high density of CD68 macrophages expression was seen in the peritumoral area if lymph node metastasis is present and is statistically associated.