Rathore Ankita Singh, Kumar Sandeep, Konwar Rituraj, Makker Annu, Negi M P S, Goel Madhu Mati
Department of Pathology, King George's Medical University, Lucknow, India.
Indian J Med Res. 2014 Sep;140(3):361-9.
BACKGROUND & OBJECTIVES: Tumour infiltrating lymphocytes (TILs) represent the host immune response against cancer cells associated with good or bad prognosis in different tumour types. This study was undertaken to evaluate the significance of CD3+, CD4+ and CD8+ TILs in breast cancer tissues in relation to clinico-pathological variables and survival outcome.
Immunohistochemistry (IHC) was performed with antibodies against CD3, CD4 and CD8 antigens on formalin-fixed paraffin-embedded tissue sections of 150 breast cancer patients. Intratumoural and stromal TIL counting was performed semiquantitatively.
The higher CD3+, CD4+ and CD8+ intratumoural and stromal counts showed independent and direct association with good prognosis. The prognostic predictor value of intratumoural counts was higher than stromal counts. The independent associations of intratumoural and stromal counts became more prominent when adjusted with stage and grade, respectively. Among intratumoural counts, the high (++/+++) CD4+ count (OR=3.85, 95% CI=3.28-16.71, P<0.001) showed the highest survival followed by CD3+ (OR=2.70, 95% CI=1.76-8.30, P=0.001) and CD8+ (OR=2.58, 95% CI=1.55-5.86, p0 =0.001) the least when compared to respective low (+) counts. In contrast, among stromal counts, the high CD8+ count (OR=3.13, 95% CI=2.20-9.57, p0 <0.001) showed the highest survival followed by CD4+ (OR=3.02, 95% CI=2.07-8.89, p0 <0.001) and CD3+ (OR=2.45, 95% CI=1.53-6.73, p0 =0.002) the least.
INTERPRETATION & CONCLUSIONS: Our results suggest that intratumoural CD4+ and stromal CD8+ counts by immunohistochemistry may serve as an independent prognosticator for favourable outcome in breast cancer.
肿瘤浸润淋巴细胞（TILs）代表宿主针对癌细胞的免疫反应，在不同肿瘤类型中与预后好坏相关。本研究旨在评估乳腺癌组织中CD3⁺、CD4⁺和CD8⁺ TILs与临床病理变量及生存结果的关系。
对150例乳腺癌患者的福尔马林固定石蜡包埋组织切片，用抗CD3、CD4和CD8抗原的抗体进行免疫组织化学（IHC）检测。对瘤内和间质TILs进行半定量计数。
瘤内和间质中较高的CD3⁺、CD4⁺和CD8⁺计数与良好预后呈独立且直接的关联。瘤内计数的预后预测价值高于间质计数。分别根据分期和分级进行调整后，瘤内和间质计数的独立关联变得更加显著。在瘤内计数中，高（++/+++）CD4⁺计数（OR = 3.85，95%CI = 3.28 - 16.71，P < 0.001）的生存率最高，其次是CD3⁺（OR = 2.70，95%CI = 1.76 - 8.30，P = 0.001），CD8⁺（OR = 2.58，95%CI = 1.55 - 5.86，P = 0.001）与各自低（+）计数相比生存率最低。相比之下，在间质计数中，高CD8⁺计数（OR = 3.13，95%CI = 2.20 - 9.57，P < 0.001）的生存率最高，其次是CD4⁺（OR = 3.02，95%CI = 2.07 - 8.89，P < 0.001），CD3⁺（OR = 2.45，95%CI = 1.53 - 6.73，P = 0.002）与各自低（+）计数相比生存率最低。
我们的结果表明，通过免疫组织化学检测的瘤内CD4⁺和间质CD8⁺计数可作为乳腺癌良好预后的独立预后指标。
