Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective study

Background: TOX is a transcription factor that is implicated in the regulation of T cell exhaustion in tumors. TOX has been proven to have prognostic value in some malignant tumors. We aim to analyze the expression of TOX in breast cancer patients, and the association between TOX and prognostic sign...

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Main Authors: Chunlei Tan, Danping Wu, Xiaotian Yang, Shiyuan Zhang, Shuqiang Liu, Boqian Yu, Xiao Yu, Yuting Xiu, Yuanxi Huang
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844024172118
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author Chunlei Tan
Danping Wu
Xiaotian Yang
Shiyuan Zhang
Shuqiang Liu
Boqian Yu
Xiao Yu
Yuting Xiu
Yuanxi Huang
author_facet Chunlei Tan
Danping Wu
Xiaotian Yang
Shiyuan Zhang
Shuqiang Liu
Boqian Yu
Xiao Yu
Yuting Xiu
Yuanxi Huang
author_sort Chunlei Tan
collection DOAJ
description Background: TOX is a transcription factor that is implicated in the regulation of T cell exhaustion in tumors. TOX has been proven to have prognostic value in some malignant tumors. We aim to analyze the expression of TOX in breast cancer patients, and the association between TOX and prognostic significance in patients with breast cancer. Methods: 313 breast cancer patients were enrolled into this study. The expression of TOX was determined by immunohistochemistry assay. Survival curves were performed by Kaplan-Meier and log-rank test. The potential independent factors were assessed by Cox regression analyses. Nomogram models, calibration curve, decision curve analyses were applied to analyze the clinical utility of predictive models. Results: According to semi-quantitative scoring, 129 patients were classified into low group, and 184 patients were classified into high group. Patients with high expression of TOX had a longer survival than those with low expression of TOX (DFS: 71.70 vs. 64.05 months, χ2 = 11.6300, P = 0.00065; OS: 81.03 vs. 73.72 months, χ2 = 11.4200, P = 0.00073). Based on Cox regression analyses, multivariate analysis indicated that TOX was the potential prognostic factor for both DFS (HR: 0.412, 95 % CI: 0.248–0.684, P = 0.001) and OS (HR: 0.395, 95 % CI: 0.237–0.660, P < 0.0001). Calibration curve analysis showed that the predicted line was well-matched with baseline regarding postoperative 1-, 3-, and 5-year survival rate. Conclusions: The expression of TOX is a potential prognostic factor, and can be a promising biomarker for predicting survival in breast cancer patients.
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spelling doaj-art-bc96ced9ae1442ee8ba871e65d25a89e2025-01-17T04:50:25ZengElsevierHeliyon2405-84402025-01-01111e41180Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective studyChunlei Tan0Danping Wu1Xiaotian Yang2Shiyuan Zhang3Shuqiang Liu4Boqian Yu5Xiao Yu6Yuting Xiu7Yuanxi Huang8Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaDepartment of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaDepartment of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaDepartment of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaDepartment of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaDepartment of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaDepartment of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaDepartment of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaCorresponding author.; Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, PR ChinaBackground: TOX is a transcription factor that is implicated in the regulation of T cell exhaustion in tumors. TOX has been proven to have prognostic value in some malignant tumors. We aim to analyze the expression of TOX in breast cancer patients, and the association between TOX and prognostic significance in patients with breast cancer. Methods: 313 breast cancer patients were enrolled into this study. The expression of TOX was determined by immunohistochemistry assay. Survival curves were performed by Kaplan-Meier and log-rank test. The potential independent factors were assessed by Cox regression analyses. Nomogram models, calibration curve, decision curve analyses were applied to analyze the clinical utility of predictive models. Results: According to semi-quantitative scoring, 129 patients were classified into low group, and 184 patients were classified into high group. Patients with high expression of TOX had a longer survival than those with low expression of TOX (DFS: 71.70 vs. 64.05 months, χ2 = 11.6300, P = 0.00065; OS: 81.03 vs. 73.72 months, χ2 = 11.4200, P = 0.00073). Based on Cox regression analyses, multivariate analysis indicated that TOX was the potential prognostic factor for both DFS (HR: 0.412, 95 % CI: 0.248–0.684, P = 0.001) and OS (HR: 0.395, 95 % CI: 0.237–0.660, P < 0.0001). Calibration curve analysis showed that the predicted line was well-matched with baseline regarding postoperative 1-, 3-, and 5-year survival rate. Conclusions: The expression of TOX is a potential prognostic factor, and can be a promising biomarker for predicting survival in breast cancer patients.http://www.sciencedirect.com/science/article/pii/S2405844024172118Breast cancerTOXChemotherapyPrognosisSurvival
spellingShingle Chunlei Tan
Danping Wu
Xiaotian Yang
Shiyuan Zhang
Shuqiang Liu
Boqian Yu
Xiao Yu
Yuting Xiu
Yuanxi Huang
Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective study
Heliyon
Breast cancer
TOX
Chemotherapy
Prognosis
Survival
title Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective study
title_full Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective study
title_fullStr Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective study
title_full_unstemmed Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective study
title_short Low expression of TOX predicts poor prognosis of patients with breast cancer in the real world: A retrospective study
title_sort low expression of tox predicts poor prognosis of patients with breast cancer in the real world a retrospective study
topic Breast cancer
TOX
Chemotherapy
Prognosis
Survival
url http://www.sciencedirect.com/science/article/pii/S2405844024172118
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