Tamiolakis D, Simopoulos C, Cheva A, Lambropoulou M, Kotini A, Jivannakis T, Papadopoulos N
Department of Cytology, Regional Hospital of Alexandroupolis, Democritus University of Thrace, Greece.
Eur J Gynaecol Oncol. 2002;23(5):433-6.
Medullary carcinoma (MC) of the breast is considered to carry a more favorable prognosis than other subtypes of infiltrating ductal carcinoma. This is a biological paradox because its clinical behavior contrasts with its anaplastic morphology. MC is characterized by a dense lymphocytic infiltrate. In this study, we determined the immunological profile of tumor infiltrating lymphocytes (TILs) in MC by CD20 (L26), CD8, and CD45RO (UCHL 1) immunostaining on paraffin-embedded sections. We examined 14 cases of typical MC (TMC), 15 cases of atypical MC (AMC) classified according to Ridolfi criteria (1977) and 19 cases of poorly differentiated infiltrating ductal carcinoma (PDC-NOS). TILs were quantified separately into cells infiltrating tumor nests (intraepithelial) and cells infiltrating tumor stroma (stromal). The number of CD8 positive and CD20 positive cells infiltrating tumor nests and tumor stroma were significantly increased in TMC and AMC as opposed to the PDC-NOS group. There was a loss in the number of CD45RO positive cells, both intraepithelial and stromal, in TMC and AMC as opposed to the PDC-NOS group. We conclude that MC tumor lymphocytic infiltrate demonstrates a mixed-T cytotoxic (CD8+) and B cell (CD20+)-immunophenotypic profile. This might in part explain the improved clinical outcome of the disease.
乳腺髓样癌（MC）被认为比浸润性导管癌的其他亚型预后更好。这是一个生物学上的悖论，因为其临床行为与其间变形态形成对比。MC的特征是密集的淋巴细胞浸润。在本研究中，我们通过对石蜡包埋切片进行CD20（L26）、CD8和CD45RO（UCHL 1）免疫染色来确定MC中肿瘤浸润淋巴细胞（TILs）的免疫表型。我们检查了14例典型MC（TMC）、15例根据Ridolfi标准（1977年）分类的非典型MC（AMC）以及19例低分化浸润性导管癌（PDC-NOS）。TILs被分别量化为浸润肿瘤巢（上皮内）的细胞和浸润肿瘤基质（基质）的细胞。与PDC-NOS组相比，TMC和AMC中浸润肿瘤巢和肿瘤基质的CD8阳性细胞和CD20阳性细胞数量显著增加。与PDC-NOS组相比，TMC和AMC中上皮内和基质内的CD45RO阳性细胞数量均减少。我们得出结论，MC肿瘤淋巴细胞浸润表现出混合性T细胞毒性（CD8+）和B细胞（CD20+）免疫表型。这可能部分解释了该疾病改善的临床结果。
