Elevated CCL20 expression associates with adverse prognosis in breast cancer patients: A clinical perspective.

Background: The chemokine CCL20 exhibits pronounced expression within tumor cells, effectively facilitating tumor progression by modulating the immunosuppressive microenvironment and promoting tumor cell aggressiveness.

Methods: Breast cancer and matched adjacent normal tissues from 113 adult breast cancer patients were collected for immunohistochemical staining of CCL20, E-Cadherin, Vimentin, and N-Cadherin. The assessment evaluated the association between CCL20 expression and clinicopathological factors using Pearson's chi-squared test, EMT markers expression using Spearman's rank correlation test, both OS and DFS using Kaplan-Meier survival analysis and Cox proportional hazards regression modeling.

Results: Cytoplasmic CCL20 expression was stronger in cancer tissues, compared to normal tissue (69.9% vs 23%). Strong correlations were observed between CCL20 expression and many clinicopathological features, including tumor size (p = 0.000), estrogen receptor (ER) status (p = 0.003), Ki67 status (p = 0.000), vascular invasion (p = 0.001), and tumor-node-metastasis stage (p = 0.001). Additionally, CCL20 expression was an independent prognostic predictor for OS (HR, 3.207; 95% confidence interval [CI], 1.142 - 9.005, p = 0.027). Furthermore, a significant association between CCL20 expression and EMT markers was observed. CCL20 expression was linked to unfavorable outcomes in all patients (p = 0.000), ER-positive patients (p = 0.001), and node-positive/negative (p = 0.005/0.001) subgroups.

Conclusions: These findings highlighted that elevated CCL20 expression was linked to a more aggressive tumor phenotype and a disappointing OS in breast cancer patients, thus advocating for the consideration of CCL20 expression being a novel independent prognostic biomarker for guiding bespoke treatment strategies.