Impact of Tissue Lipocalin-2 Expression on Pathologic Response and Prognosis Following Neoadjuvant Chemotherapy in Locally Advanced Triple-Negative Breast Cancer

Objectives: This study aimed to evaluate Lipocalin-2 (Lcn-2) expression in patients with locally advanced triple-negative breast cancer (TNBC) and to investigate its association with pathological response following neoadjuvant chemo-therapy (NACT), as well as its prognostic relevance in relation to established clinicopathological parameters. Methods: Fifty-six patients with locally advanced TNBC treated at the Medical Oncology Department of SBÜ Dr. Abdur-rahman Yurtaslan Ankara Oncology Training and Research Hospital were retrospectively analyzed. Lcn-2 expression was assessed immunohistochemically. Associations between Lcn-2 expression and demographic, laboratory, clinical, and histopathological characteristics, as well as response to NACT, were evaluated using appropriate statistical methods. Results: Lcn-2 expression was detected in 53.6% of patients (n=30). Lcn-2 positivity was significantly associated with a high Ki-67 proliferation index (p=0.032), advanced clinical tumor stage (cT3–T4; p=0.043), and stage III disease (p=0.029). However, no significant association was observed between Lcn-2 expression and pathological complete response fol-lowing NACT (p=0.666). Additionally, Lcn-2 expression was not correlated with age at diagnosis, menopausal status, comorbidities, lifestyle factors, baseline CA15-3 levels, inflammatory markers, including the neutrophil-to-lymphocyte ratio, histologic subtype, presence of ductal carcinoma in situ, or lymph node involvement.
Conclusion: Lcn-2 expression appears to be associated with features indicative of tumor aggressiveness in locally advanced TNBC. Larger prospective studies are warranted to clarify its prognostic value and potential role as a therapeutic target.

Keywords: Biomarker, Neutrophil Gelatinase-Associated Lipocalin, Pathological Complete Response