Miligy Islam, Mohan Priya, Gaber Ahmed, Aleskandarany Mohammed A, Nolan Christopher C, Diez-Rodriguez Maria, Mukherjee Abhik, Chapman Caroline, Ellis Ian O, Green Andrew R, Rakha Emad A
Division of Cancer and Stem Cells, School of Medicine, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK.
Histopathology Department, Faculty of Medicine, Monofiya University, Egypt.
Histopathology. 2017 Aug;71(2):258-268. doi: 10.1111/his.13217. Epub 2017 May 26.
Tumour-infiltrating lymphocytes (TILs) are an important component of the immune response to cancer and have a prognostic value in breast cancer. Although several studies have investigated the role of T lymphocytes in breast cancer, the role of B lymphocytes (TIL-Bs) in ductal carcinoma in situ (DCIS) remains uncertain. This study aimed to assess the role of TIL-Bs in DCIS.
Eighty DCIS cases (36 pure DCIS and 44 mixed with invasive cancer) were stained immunohistochemically for B lineage markers CD19, CD20 and the plasma cell marker CD138. TIL-Bs density and localization were assessed, including relation to the in-situ and invasive components. An association with clinicopathological data and patient outcome was performed. Pure DCIS showed a higher number of TIL-Bs and lymphoid aggregates than DCIS associated with invasion. In pure DCIS, a higher number of peri- and paratumoral TIL-Bs was associated significantly with large tumour size (P = 0.016), hormone receptor (ER/PR) negative (P = 0.008) and HER2 status (P = 0.010). In tumours with mixed DCIS and invasive components, cases with high-density B lymphocytes, irrespective of their location or topographic distribution, were associated significantly with variables of poor prognosis, including larger size, high grade, lymphovascular invasion, lymph node metastases, ER/PR-negative and HER2 status. Outcome analysis showed that pure DCIS associated with higher numbers of B lymphocytes had shorter recurrence-free interval (P = 0.04); however, the association was not significant with the CD138 plasma cell count (P = 0.07).
Assessment of TIL-B cells based on location and topographic distribution can provide prognostic information. Validation in a larger cohort is warranted.
肿瘤浸润淋巴细胞（TILs）是癌症免疫反应的重要组成部分，对乳腺癌具有预后价值。尽管多项研究探讨了T淋巴细胞在乳腺癌中的作用，但B淋巴细胞（TIL-Bs）在导管原位癌（DCIS）中的作用仍不明确。本研究旨在评估TIL-Bs在DCIS中的作用。
对80例DCIS病例（36例单纯DCIS和44例合并浸润性癌）进行免疫组织化学染色，检测B细胞谱系标志物CD19、CD20和浆细胞标志物CD138。评估TIL-Bs的密度和定位，包括与原位和浸润成分的关系。分析其与临床病理数据及患者预后的相关性。单纯DCIS显示出比合并浸润的DCIS更多的TIL-Bs和淋巴样聚集物。在单纯DCIS中，肿瘤周围和瘤旁TIL-Bs数量较多与肿瘤体积大（P = 0.016）、激素受体（ER/PR）阴性（P = 0.008）及HER2状态（P = 0.010）显著相关。在合并DCIS和浸润成分的肿瘤中，无论B淋巴细胞的位置或形态分布如何，高密度B淋巴细胞的病例均与预后不良的变量显著相关，包括肿瘤体积大、高级别、淋巴血管浸润、淋巴结转移、ER/PR阴性及HER2状态。预后分析显示，B淋巴细胞数量较多的单纯DCIS患者无复发生存期较短（P = 0.04）；然而，与CD138浆细胞计数的相关性不显著（P = 0.07）。
基于位置和形态分布评估TIL-B细胞可提供预后信息。有必要在更大的队列中进行验证。
