Pujani Mukta, Jain Harsh, Chauhan Varsha, Agarwal Charu, Singh Kanika, Singh Mitasha
Department of Pathology, ESIC Medical College & Hospital, Faridabad, Haryana, India.
ESIC Medical College & Hospital, Faridabad, Haryana, India.
Breast Dis. 2020;39(2):61-69. doi: 10.3233/BD-200442.
Tumour infiltrating lymphocytes (TILs) exhibit the local immune response directed against tumor growth and metastasis. TILs have emerged as a tool to assess immune-reactivity in various malignancies including colon, ovary, lung, bladder, breast etc as well as independent marker of favourable prognosis in many tumors. TILs in breast cancer (BC) play a role in tumor response to therapy in the adjuvant and neoadjuvant settings, especially in triple-negative cancers.
MATERIAL & METHODS: This cross sectional study comprised of 101cases of invasive breast carcinoma. For each case, a representative 5 μm H&E stained section was selected and the clinicopathological details were recorded. To establish the molecular subtype of breast cancer, immunohistochemistry for ER, PR and Her2neu was done. Both stromal (sTIL) and intratumoral (iTIL) TILs were assessed based on the recommendations of the International TIL Working Group (ITILWG).
A statistically significant difference was observed in the mean sTIL as well as iTIL scores and tumor grade, size, molecular type and lymph node metastasis. A signification correlation was observed between stromal TIL and tumor grade, lymph node metastasis, molecular subtype and mitosis. Intratumoral TIL showed a significant correlation with tumor size, mitosis, tumor grade, distant metastasis, stage and lymph node metastasis. Moreover, stromal and intratumoral TIL showed a highly significant correlation with each other.
The ITILWG recommendations are reproducible and reliable for the evaluation of sTILs and iTILs. TILs, as evaluated on Hematoxylin and eosin (H&E) slides, has been shown in numerous studies now to be a reliable, reproducible, inexpensive and readily available marker of pre-existing antitumor immunity in breast cancer. We suggest that TILs should be evaluated for each case of breast carcinoma and should be part of histopathology report.
肿瘤浸润淋巴细胞（TILs）表现出针对肿瘤生长和转移的局部免疫反应。TILs已成为评估包括结肠癌、卵巢癌、肺癌、膀胱癌、乳腺癌等各种恶性肿瘤免疫反应性的工具，也是许多肿瘤预后良好的独立标志物。乳腺癌（BC）中的TILs在辅助和新辅助治疗环境中对肿瘤治疗反应中发挥作用，尤其是在三阴性癌症中。
本横断面研究包括101例浸润性乳腺癌病例。对于每个病例，选择一张代表性的5μm苏木精和伊红（H&E）染色切片，并记录临床病理细节。为确定乳腺癌的分子亚型，进行了雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（Her2neu）的免疫组织化学检测。根据国际TIL工作组（ITILWG）的建议评估基质（sTIL）和肿瘤内（iTIL）TILs。
在平均sTIL以及iTIL评分与肿瘤分级、大小、分子类型和淋巴结转移之间观察到统计学上的显著差异。在基质TIL与肿瘤分级、淋巴结转移、分子亚型和有丝分裂之间观察到显著相关性。肿瘤内TIL与肿瘤大小、有丝分裂、肿瘤分级、远处转移、分期和淋巴结转移之间显示出显著相关性。此外，基质和肿瘤内TIL之间显示出高度显著的相关性。
ITILWG的建议对于评估sTILs和iTILs是可重复且可靠的。现在大量研究表明，在苏木精和伊红（H&E）切片上评估的TILs是乳腺癌中预先存在的抗肿瘤免疫的可靠、可重复、廉价且易于获得的标志物。我们建议对每例乳腺癌病例都应评估TILs，并且应将其作为组织病理学报告的一部分。
