The Relationship Between Tumor Infiltrating T Lymphocyte Density with Prognostic Factors in Breast Cancer

Abstract

Introduction: Tumor-infiltrating lymphocytes are immune system cells in the tumor microenvironment and play a critical role in the immune response to cancer. In breast carcinoma, it has been demonstrated that the amount of tumor-infiltrating lymphocytes may have prognostic and predictive importance. In our study, inflammatory cells in breast cancer tumor tissues were evaluated considering the TILs Working Group standards and their relationship with the prognostic factors. Material Method: Mastectomy and breast-conserving surgery materials of 100 patients with the diagnosis of Invasive Carcinoma, No Special Type (NST) who did not receive neoadjuvant chemotherapy and who were examined in the Pathology Department laboratory of Sakarya University Faculty of Medicine between 2011 and 2015 were included in the study and prognostic parameters including lymph node metastasis, tumor diameter stage, histological grade of the tumor, estrogen; progesterone and Her2 receptor status were determined. Results: Fifty of the cases had lymph node metastasis, while 50 patients did not have lymph node metastasis. When the distribution of patients according to the histological grade of the tumors was examined among the subgroups of variables related to the prognosis of the patients, 24 patients were grade 1, 44 patients were grade 2 and 32 patients were grade 3. A statistically significant positive correlation was observed between the grade 1 and grade 3 groups in terms of intratumoral stromal CD8 positive T lymphocyte infiltration according to different grades. Conclusion: According to our study, it was determined that the density of CD8(+) T lymphocyte infiltration was higher in tumors with higher grade. Our study is important in terms of creating awareness that the increase in the density of lymphocytes infiltrating the tumor may have prognostic and predictive value.

Keywords

• Tumor-infiltrating lymphocytes
• Breast cancer
• Tumor grade

Meme Karsinomunda Tümörü infiltre eden T Lenfositlerin Yoğunluğunun Prognostik Faktörlerle İlişkisi

Abstract

Giriş: Tümörü infiltre eden lenfositler, tümör mikroçevresindeki immün sistem hücreleridir ve kansere karşı oluşan immün yanıtta kritik rol oynar. Meme karsinomunda, tümörü infiltre eden lenfositlerin miktarının prognostik ve prediktif önemi olabileceği ortaya konmuştur. Çalışmamızda, meme kanserine ait tümör dokularındaki inflamatuar hücreler, TILs Working Group standartları göz önünde bulundurularak değerlendirilmiş ve prognostik faktörler ile ilişkisine bakılmıştır. Materyal Metod: Sakarya Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı laboratuvarında 2011-2015 yılları arasında incelenen, İnvaziv Karsinom, Özel Tip İçermeyen (NST) tanılı, neoadjuvan kemoterapi almamış 100 hastaya ait mastektomi ve meme koruyucu cerrahi materyalleri çalışmaya dahil edilerek, lenf nodu metastazı, tümör çapı evresi, tümörün histolojik derecesi, östrojen; progesteron ve Her2 reseptörü durumu olmak üzere prognostik parametreleri belirlendi. Tümör bloklarından elde edilen kesitlere CD4(+) ve CD8(+) pozitif lenfositleri tespit etmek için immunohistokimyasal çalışma yapıldı. Belirlenen prognostik parametrelerle inflamatuar hücre yoğunluğu arasındaki ilişki değerlendirildi. Bulgular: Vakaların 50’sinde lenf nodu metastazı mevcut iken, 50 hastada lenf nodu metastazı yoktu. Hastalara ait prognoz ile ilişkili değişkenlerin alt gruplarından tümörlerin histolojik derecesine göre hasta dağılımına bakıldığında 24 hasta derece 1, 44 hasta derece 2 ve 32 hasta derece 3 idi. Farklı grade ‘lere göre intratümöral stromal CD8 pozitif T lenfosit infiltrasyonu açısından grade 1 ve grade 3 grupları arasında istatistiksel olarak anlamlı pozitif korelasyon görüldü. Sonuç: Çalışmamıza göre derecesi yüksek tümörlerde CD8(+) T lenfosit infiltrasyonu yoğunluğunun daha fazla olduğu saptanmıştır. Çalışmamız tümörü infiltre eden lenfositlerin yoğunluğundaki artışın prognostik ve prediktif değerinin olabileceği konusunda farkındalık oluşturması açısından önemlidir.

Keywords

• Tümörü infiltre eden lenfositler
• Meme kanseri
• Tümör derecesi

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