Department of Pathology, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium; Breast Clinic, King Albert II Cancer Institute, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
Department of Pathology, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
Ann Diagn Pathol. 2020 Dec;49:151634. doi: 10.1016/j.anndiagpath.2020.151634. Epub 2020 Sep 19.
A combination of Sox10 and GATA3 was previously identified as a marker for metastatic triple-negative breast cancer (TNBC), but it is uncertain whether their expression is associated with pathological complete response (pCR) after neoadjuvant chemotherapy (NAC). This study investigates the predictive value of clinicopathological characteristics, as well as protein expression of Sox10, GATA3, p53 and p63, in a consecutive series of TNBC patients treated with NAC. Archived hematoxylin & eosin stained slides of core biopsies and resection specimens from 35 TNBC patients were reviewed. The following clinicopathological characteristics were determined at the biopsy level: age at diagnosis, cancer type, Nottingham grade, lympho-vascular invasion, syncytial growth, necrosis, clear cell differentiation, myxoid peritumor stroma, stromal tumor-infiltrating lymphocytes (sTILs) and presence of an in situ component. The MD Anderson residual cancer burden (RCB) score and corresponding RCB class were determined. Immunohistochemistry for Sox10, p53, GATA3 and p63 was performed at the biopsy level. sTILs, either as a continuous or as a dichotomous variable, were the only parameter that was significantly associated with pCR in univariable and multivariable analyses. Assessment of sTILs showed moderate to good interobserver agreement. High sTILs (≥40%) were significantly associated with increased pCR rates, and this association was observer-independent. This retrospective study of a consecutive community-based cohort of TNBC patients confirms that sTILs are a robust, observer-independent predictor for therapeutic response after NAC. The combination of Sox10, GATA3 and p53 immunoreactivity is unlikely to harbor any predictive value for pCR in TNBC.
Sox10 和 GATA3 的组合先前被确定为转移性三阴性乳腺癌 (TNBC) 的标志物，但它们的表达是否与新辅助化疗 (NAC) 后的病理完全缓解 (pCR) 相关尚不确定。本研究调查了临床病理特征以及 Sox10、GATA3、p53 和 p63 蛋白表达在连续系列接受 NAC 治疗的 TNBC 患者中的预测价值。对 35 例 TNBC 患者的核心活检和切除标本的存档苏木精和伊红染色切片进行了回顾。在活检水平确定了以下临床病理特征：诊断时的年龄、癌症类型、诺丁汉分级、淋巴血管浸润、合胞体生长、坏死、透明细胞分化、黏液样肿瘤周围基质、基质肿瘤浸润淋巴细胞 (sTILs) 和原位成分的存在。确定了 MD 安德森残留癌负担 (RCB) 评分和相应的 RCB 分类。在活检水平进行 Sox10、p53、GATA3 和 p63 的免疫组织化学染色。sTILs（无论是连续变量还是二分类变量）是唯一在单变量和多变量分析中与 pCR 显著相关的参数。sTILs 的评估显示观察者间具有中度至良好的一致性。高 sTILs（≥40%）与增加的 pCR 率显著相关，这种相关性与观察者无关。这项对 TNBC 患者连续社区队列的回顾性研究证实，sTILs 是 NAC 后治疗反应的一种强大、与观察者无关的预测指标。Sox10、GATA3 和 p53 免疫反应的组合不太可能对 TNBC 的 pCR 具有任何预测价值。
