Cancerul mamar (CM) şi diabetul zaharat tip 2 (DZ) sunt patologii predominante în structura morbidităţii oncologice şi endocrine, ale căror incidenţă este în creştere la nivel global, cu impact sociomedical considerabil. Scopul studiului: Determinarea particularităţilor imuno-genetice şi clinico-morfologice la pacientele cu CM asociat cu DZ. Material şi metode: Au fost investigate 246 paciente cu CM, dintre care 107 - cu CM asociat cu DZ. Rezultate: Pacientele cu CM asociat cu DZ tip 2 au prezentat următoarele particularităţi vs omoloagele nondiabetice: 1. imunodepresie antitumorală vadită: CD16 (14,3±0,72 vs 21,2±0,56) (p<0,01) şi generală, CD4 (27,4±1,8 vs 35,7±0,15) (p<0,01) şi CD8 (14,3±0,2 vs 19,3±0,3) (p <0,01). 2. Prezenţa mutaţiei BRCA 1 5382insC a fost depistată de 2 ori mai frecvent, (21,87% vs 11,36%) 3. Frecvenţa mai înaltă a formelor clinice difuze – 10,28% vs 5,04%, a creşterii multicentrice - 9,35%, vs 4,32% şi a unui grad mai avansat de extindere loco-regională - 24,3% vs 10,7%. 4. particularităţile morfologice: frecvenţa mai înaltă a carcinomului lobular -12,14% vs 5,03%, a carcinomului mixt - ductal şi lobular -10,28% vs 4,31% şi a formelor rare: medulare - 4,67% vs 2,88% şi mucinoase - 6,54% vs 2,88%. 5. predominanţa formelor imunohistochimice cu un grad de agresivitate sporit: subtipurile triplu negativ 21,49% şi Her2/neu pozitiv - 25,23%, versus paciente fără diabet - 11,51% vs 16,54%. Concluzii: Cancerul mamar asociat cu diabetul zaharat tip 2 evoluează pe un teren imun precar, are o susceptibiliate genetică înaltă şi prezintă forme clinico-mofologice şi imunogenetice mai agresive, ce condiţionează o tactica personalizată de tratament.

Breast Cancer (BC) and Diabetes Mellitus Type 2 (DM) are predominant pathologies in the oncological and endocrine morbidity structure, whose incidence is increasing globally, with considerable socio medical impact. Purpose of the study: Determination of immunogenic and clinical-morphological particularities in patients with BC associated with DM. Material and Methods: 246 breast cancer patients were investigated, 107 of whom were BC associated with DM. Results: Patients with BC associated with DM showed the following peculiarities versus non-diabetic counterparts: 1. Clear anti-tumor immunodepression: CD16 (14.3±0.72 vs. 21.2±0.56) (p<0.01) and overall CD4 (27.4±1.8 vs 35.7±0.15) (p <0.01) and CD8 (14.3±0.2 vs 19.3±0.3) (p <0.01). 2. The presence of the BRCA1 5382insC mutation was detected 2 times more frequently (21.87% vs 11.36%). 3. The higher incidence of diffuse clinical forms - 10.28% vs 5.04%, of the multicentre growth - 9.35% vs 4.32% and a more advanced degree of loco-regional expansion - 24.3% vs 10.7%. 4. morphological particularities: higher frequency of lobular carcinoma - 12,14% vs 5,03%, mixed carcinoma ductal and lobular - 10,28% vs 4,31% and rare forms: medullare - 4,67% vs 2.88% and mucinous - 6.54% vs 2.88%. 5. predominance of immunohistochemical forms with an increased aggressiveness: triple negative subtypes 21.49% and Her2/neu positive - 25.23%, compared to those without diabetes - 11.51% vs. 16.54%. Conclusions: Breast cancer associated with type 2 diabetes evolves on a precarious immune site, has a high genetic susceptibility, and presents more aggressive clinical, morphogenic and immunogenic forms that condition a personalized treatment tactic.