Evaluation of tumor infiltrating lymphocytes as a prognostic biomarker in patients with ductal carcinoma in situ of the breast.

IF 3 3区 医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2024-11-01 Epub Date: 2024-08-24 DOI:10.1007/s10549-024-07466-9
Camila Vitola Pasetto, Fernando Nalesso Aguiar, Marcella Bassan Peixoto, Maíra Teixeira Dória, Bruna Salani Mota, Jonathan Yugo Maesaka, José Roberto Filassi, Edmund Chada Baracat, Rodrigo Gonçalves
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Abstract

Purpose: To assess the association between tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ (DCIS) samples and disease recurrence.

Methods: This retrospective cohort study included women aged 18 years and older who underwent treatment between January 2007 and December 2020. Male patients, individuals diagnosed with invasive or microinvasive disease based on anatomopathological examination of surgical specimens, and those with a personal history of any other cancers were excluded. Additionally, the presence of "touching TILs" (lymphocytes in direct contact with tumor cells) and periductal desmoplasia were evaluated as complementary methods to represent the immunological microenvironment. The primary outcome was relapse-free survival based on TIL quantification adjusted for potential confounders. Pathologists assessed TILs in the sample with the highest tumor representation and quantified them as a percentage. Survival was evaluated using Kaplan‒Meier curves, log-rank tests, and Cox regression models.

Results: A total of 191 patients met the eligibility criteria. The mean follow-up duration was 77.2 months, with a recurrence rate of 9.2%. Patients with TILs ≥ 17% had a greater risk of recurrence (HR 2.97, 95% CI 1.17-7.51; p = 0.02). Additionally, focal necrosis (HR 6.4, 95% CI 1.39-34.71; p = 0.018) or comedonecrosis (HR 4.53, 95% CI 1.34-15.28; p = 0.015) were associated with increased recurrence risk. According to the multivariate model, comedonecrosis and TILs ≥ 17% were significantly associated with recurrence (p = 0.034 and p = 0.035, respectively). Regarding the evaluations of "touching TILs" and periductal desmoplasia, no statistical significance was found when assessing their association with disease recurrence.

Conclusion: In our cohort, a high percentage of TILs (≥ 17%) and the presence of comedonecrosis were independently associated with DCIS recurrence.

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将肿瘤浸润淋巴细胞作为乳腺导管原位癌患者预后生物标志物的评估。
目的:评估导管原位癌(DCIS)样本中肿瘤浸润淋巴细胞(TILs)与疾病复发之间的关系:这项回顾性队列研究纳入了 2007 年 1 月至 2020 年 12 月期间接受治疗的 18 岁及以上女性。男性患者、根据手术标本的解剖病理学检查被诊断为浸润性或微小浸润性疾病的患者以及有其他癌症病史的患者均被排除在外。此外,还评估了 "接触性TIL"(与肿瘤细胞直接接触的淋巴细胞)和导管周围脱钙化的存在情况,作为代表免疫微环境的补充方法。主要结果是基于TIL定量的无复发生存期,并对潜在的混杂因素进行了调整。病理学家对肿瘤代表性最高的样本中的TIL进行评估,并将其量化为一个百分比。采用卡普兰-梅耶曲线、对数秩检验和考克斯回归模型对生存率进行评估:共有 191 名患者符合资格标准。平均随访时间为 77.2 个月,复发率为 9.2%。TIL≥17%的患者复发风险更高(HR 2.97,95% CI 1.17-7.51;P = 0.02)。此外,局灶性坏死(HR 6.4,95% CI 1.39-34.71;P = 0.018)或彗星状坏死(HR 4.53,95% CI 1.34-15.28;P = 0.015)与复发风险增加有关。根据多变量模型,合并颌骨坏死和 TIL ≥ 17% 与复发显著相关(分别为 p = 0.034 和 p = 0.035)。关于 "触及TILs "和导管周围脱钙化的评估,在评估其与疾病复发的相关性时未发现统计学意义:结论:在我们的队列中,高比例的TILs(≥ 17%)和存在粉瘤与DCIS复发独立相关。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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Correction: FBLN2 is associated with basal cell markers Krt14 and ITGB1 in mouse mammary epithelial cells and has a preferential expression in molecular subtypes of human breast cancer. A randomised trial comparing 6-monthly adjuvant zoledronate with a single one-time dose in patients with early breast cancer. Alterations in the expression of homologous recombination repair (HRR) genes in breast cancer tissues considering germline BRCA1/2 mutation status. Efficacy of antiobesity medications among breast cancer survivors taking aromatase inhibitors. Cost containment analysis of superparamagnetic iron oxide (SPIO) injection in patients with ductal carcinoma in situ.
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