Low TFPI2 expression is associated with poor prognosis and defective immune cell infiltration in breast cancer disease

Abstract

Background Breast cancer is the leading cause of death in female cancer population worldwide. The mainstay treatment for breast cancer includes chemotherapy, targeted therapy, endocrine therapy and immunotherapy. Tissue factor pathway inhibitor 2 (TFPI2) plays an important role in balancing the activity of various enzymes in the human environment. However, the correlation of TFPI2 to the prognosis and the immune infiltration in breast cancer has not been reported. Methods We firstly analyzed the expression level of TFPI2 via high-throughput sequencing, clinical sample detection and cancer genome profiling (TCGA). Results TFPI2 expression was significantly downregulated in different subtypes of breast cancer samples. Downregulation of TFPI2 expression was associated with multiple clinical features and poor prognosis. In the tumor microenvironment (TME), TFPI2 is positively correlated with immune cells and immune modulators (chemokines, receptors, immunostimulants, immunosuppressants and MHC). With TFPI2 upregulation, immune and stromal components significantly increased. Conclusion This is the first comprehensive study to reveal that TFPI2 may serve as a novel prognostic biomarker associated with tumor immune infiltration and provide a potential therapeutic target in breast cancer.