Seroprevalence and risk factors for Toxoplasma gondii infection in women with breast tumors in Eastern China.

OBJECTIVE

To investigate the seroprevalence and risk factors of Toxoplasma gondii (T. gondii) infection in females with breast tumors in eastern China.

METHODS

This case-control study enrolled 610 breast tumor patients and 610 healthy controls. Serum anti-T. gondii IgG and IgM antibodies were measured using ELISA. Multivariate logistic regression analysis was used to analyze relevant risk factors.

RESULTS

The overall T. gondii seroprevalence was higher in breast tumor patients than that in controls (18.85% vs. 9.67%, P=0.001), with elevated IgG (P=0.001) and IgM (P=0.011) levels. Consumption of undercooked seafood (OR=3.00, P=0.001) and rural living environment (OR=1.65, P=0.035) were independent risk factors. There was no significant difference in the T. gondii seroprevalence between patients with malignant and benign breast tumors (P=0.430). However, the elevated infection rate was associated with tumor invasiveness characteristics, including a tumor-infiltrating lymphocyte ratio >20%, high Ki67 expression (up to 30%), and HER2 amplification (all P<0.05). The constructed predictive model demonstrated good discriminative power for T. gondii infection (AUC=0.804, 95% CI: 0.76-0.85) and good calibration (MAE=0.010). Decision curve analysis confirmed that the model provided significant net clinical benefit within the threshold probability range of 0-0.8.

CONCLUSION

T. gondii infection is highly prevalent in female patients with breast tumors and is correlated with specific environmental exposures and clinicopathologic features of tumor invasiveness. This robust predictive model can be used accurately and reliably for individualized risk assessment of T. gondii infection in women with breast tumors. It can assist clinicians in developing targeted screening and intervention plans, maximizing clinical benefits while reducing unnecessary diagnostic and treatment procedures.