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Profiling peripheral MDSCs and Tregs in breast cancer: clinical significance and prediction of lymph node metastasis

Clin Transl Oncol. 2026 May 22. doi: 10.1007/s12094-026-04306-8. Online ahead of print.

ABSTRACT

BACKGROUND: Myeloid-derived suppressor cells (MDSCs) constitute a heterogeneous population of immature bone marrow cells that have been demonstrated to exert immunosuppressive effects in various cancers. However, research on their role in breast cancer remains limited.

METHODS: We selected peripheral blood samples from 236 breast cancer patients with complete clinical and pathological data who met inclusion criteria, and from 33 healthy individuals undergoing routine health examinations, all enrolled at the Fourth Hospital of Hebei Medical University between 2021-2022. Flow cytometry was employed to detect peripheral blood MDSCs, promyelocytic bone marrow-derived suppressor cells (PMN-MDSCs), monocytic bone marrow derived inhibitory cells (M-MDSCs), and regulatory T cells (Tregs) in peripheral blood, while analyzing their association with clinical-pathological characteristics of breast cancer patients.

RESULTS: Results showed that compared with healthy individuals, breast cancer patients exhibited significantly higher levels of MDSCs and Treg cells in peripheral blood (P< 0.05). After multivariate adjustment for potential clinical confounders, these differences did not reach statistical significance (Adjusted P > 0.05). Among breast cancer patients, those with lymph node metastasis exhibited significantly higher levels of MDSCs cells compared to those without lymph node metastasis (P< 0.05). Receiver operator characteristic (ROC) curve analysis revealed that combined detection of MDSCs + Perineural invasion (PNI) demonstrated higher diagnostic value than either MDSCs alone, suggesting enhanced sensitivity for clinical management in breast cancer.

CONCLUSION: This study confirms that peripheral blood MDSCs have certain value in the identification of lymph node metastasis in early breast cancer and have the potential to serve as a predictive factor for lymph node metastasis. The predictive model constructed by integrating MDSCs levels with the key pathological feature of perineural invasion (PNI) has good predictive performance. Ultimately, the assessment of MDSC expression holds substantial promise as a reliable biomarker to guide clinical decision-making and monitor patient prognosis.

PMID:42171980 | DOI:10.1007/s12094-026-04306-8

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