Masili-Oku Sergio Mitsuo, Almeida Bernardo Gomes Lacerda de, Bacchi Carlos Eduardo, Filassi Jose Roberto, Baracat Edmund Chada, Carvalho Filomena Marino
Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Instituto do Cancer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Laboratory of Pathology, Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil.
Breast. 2017 Feb;31:34-39. doi: 10.1016/j.breast.2016.10.012. Epub 2016 Nov 2.
Triple-negative breast carcinomas (TNBCs) correspond to a molecular heterogeneous disease defined by lack of estrogen and progesterone receptor expression, and the absence of overexpression and/or amplification of HER2. Recent data indicate that clinical outcome in TNBC is affected by tumor-infiltrating lymphocytes, suggesting that they can benefit from immunotherapies. We selected 116 consecutive premenopausal patients with TNBC to compare the immunohistochemical profile of the group rich in tumor-infiltrating lymphocytes with those without this characteristic.
We reviewed all the original histological sections to assess pathological features, and to select a representative area for tissue microarrays and immunohistochemical study. Estrogen and progesterone receptors, HER2 and Ki-67 were evaluated in whole histological sections. The following markers were analyzed in tissue microarrays sections: androgen receptor, cytokeratin 5/6, cytokeratin 14, epidermal growth factor receptor (EGFR), vimentin, p16, claudin-3, -4, and -7, p63, and aldehyde dehydrogenase isoform 1 (ALDH1). Lymphocyte-predominant breast cancer (LPBC) was defined by the presence of more than 50% of lymphocytes in the intratumoral stroma.
Twenty-six (22.4%) patients present tumors classified as LPBC and 90 (77.6%) as non-LPBC. The two groups were similar regarding age of patients, tumor grade and Ki-67 positive cells. LPBC cases presented lower frequency of expression of the basal cytokeratins, EGFR, and basal-like immunoprofile. There was a trend to higher expression of ALDH1 by stromal intratumoral cells. The expression of all other markers were similar in the two groups.
Lymphocyte-predominant TNBC in premenopausal patients are mostly of non-basal phenotype.
三阴性乳腺癌（TNBC）是一种分子异质性疾病，其定义为缺乏雌激素和孕激素受体表达，且HER2无过表达和/或扩增。近期数据表明，TNBC的临床结局受肿瘤浸润淋巴细胞影响，提示患者可能从免疫治疗中获益。我们选取了116例连续的绝经前TNBC患者，比较富含肿瘤浸润淋巴细胞组与无此特征组的免疫组化特征。
我们复查了所有原始组织学切片以评估病理特征，并选取一个代表性区域制作组织芯片及进行免疫组化研究。在全组织学切片中评估雌激素和孕激素受体、HER2及Ki-67。在组织芯片切片中分析以下标志物：雄激素受体、细胞角蛋白5/6、细胞角蛋白14、表皮生长因子受体（EGFR）、波形蛋白、p16、闭合蛋白-3、-4和-7、p63以及醛脱氢酶同工型1（ALDH1）。肿瘤内基质中淋巴细胞占比超过50%定义为淋巴细胞为主型乳腺癌（LPBC）。
26例（22.4%）患者的肿瘤分类为LPBC，9例（77.6%）为非LPBC。两组在患者年龄、肿瘤分级及Ki-阳性细胞方面相似。LPBC病例中基底细胞角蛋白、EGFR及基底样免疫表型的表达频率较低。肿瘤内基质细胞中ALDH1表达有升高趋势。两组中所有其他标志物的表达相似。
绝经前患者中淋巴细胞为主型TNBC大多为非基底表型。
