Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.
Histopathology. 2020 Nov;77(5):749-759. doi: 10.1111/his.14181. Epub 2020 Sep 26.
Tumour-infiltrating lymphocytes (TILs) are prognostic in invasive breast cancer; however, their prognostic significance in ductal carcinoma in situ (DCIS) has not been established. The Oncotype DX (ODX) Breast DCIS Score test is a genomic assay used to predict the local recurrence risk. The aims of this study were to quantify TILs in DCIS by the use of three methodologies, and correlate them with the ODX DCIS Score.
We studied 97 DCIS cases, all with an ODX DCIS Score. Cases with a low ODX DCIS Score were considered as one group, and those with an intermediate/high ODX Score were considered together. TILs were quantified on haematoxylin and eosin-stained slides. The methodologies used to quantify TILS included assessment of stromal TILs, assessment of touching TILs, and assessment of circumferential TILS. In cases with >5% stromal TILS, the percentage of stromal TILS was considered to be high. In cases with a mean number of more than five touching TILs per DCIS duct, TILs were considered to be present. The ODX DCIS Score was intermediate/high in 27 (28%) cases and low in 70 (72%) cases. There were >5% stromal TILs in 33 (34%) cases, and more than five touching TILs per DCIS duct in 15 (15%) cases; circumferential TILs were present in nine (9%) cases. In univariate analysis, a low ODX DCIS Score showed significant associations with absent touching TILS (P = 0.027), stromal TILs < 5% (P = 0.031), and absent circumferential TILs (P = 0.002). In logistic regression analysis adjusted for necrosis and nuclear grade, touching TILs and circumferential TILs showed significant associations with the ODX DCIS Score, whereas stromal TILs did not.
Our results suggest that both the presence of TILs and the spatial arrangement of TILs or close proximity of TILs to DCIS, and TILs touching or encircling DCIS, may be predictive of recurrence.
肿瘤浸润淋巴细胞（TILs）在浸润性乳腺癌中具有预后意义；然而，其在导管原位癌（DCIS）中的预后意义尚未确定。Oncotype DX（ODX）乳腺 DCIS 评分检测是一种用于预测局部复发风险的基因组检测。本研究的目的是使用三种方法学来量化 DCIS 中的 TILs，并将其与 ODX DCIS 评分相关联。
我们研究了 97 例 DCIS 病例，所有病例均进行了 ODX DCIS 评分。低 ODX DCIS 评分的病例被视为一组，而中间/高 ODX 评分的病例被视为一组。TILs 在苏木精和伊红染色切片上进行量化。用于量化 TILS 的方法包括评估间质 TILs、评估触碰到的 TILs 和评估环绕 TILs。在间质 TILS 百分比大于 5%的病例中，认为间质 TILS 百分比高。在每个 DCIS 导管中平均有超过 5 个触碰到的 TIL 的情况下，认为存在 TILs。27 例（28%）病例的 ODX DCIS 评分中等/高，70 例（72%）病例的 ODX DCIS 评分低。33 例（34%）病例的间质 TILS 百分比大于 5%，15 例（15%）病例的每个 DCIS 导管中触碰到的 TILs 多于 5 个，9 例（9%）病例存在环绕 TILs。在单因素分析中，低 ODX DCIS 评分与触碰到的 TILs 缺失显著相关（P=0.027），间质 TILs<5%（P=0.031）和不存在环绕 TILs（P=0.002）显著相关。在调整了坏死和核分级的逻辑回归分析中，触碰到的 TILs 和环绕 TILs与 ODX DCIS 评分显著相关，而间质 TILs 则不然。
我们的研究结果表明，TILs 的存在以及 TILs 的空间排列或 TILs 与 DCIS 的接近程度，以及 TILs 触碰到或环绕 DCIS，可能与复发相关。
