Elevated CCL20 expression was associated with poor prognosis for breast cancer.

BACKGROUND: The chemokine (C-C motif) ligand 20 (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 chi-squared test, epithelial-mesenchymal transition (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 overall survival (OS) (hazard ratio [HR], 3.207; 95% 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. CONCLUSION: 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.