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优化肿瘤浸润淋巴细胞评估用于三阴性乳腺癌预后。

Optimized tumour infiltrating lymphocyte assessment for triple negative breast cancer prognostics.

机构信息

Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Pathology, Nijmegen, the Netherlands.

Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Pathology, Nijmegen, the Netherlands.

出版信息

Breast. 2021 Apr;56:78-87. doi: 10.1016/j.breast.2021.02.007. Epub 2021 Feb 17.


DOI:10.1016/j.breast.2021.02.007
PMID:33640523
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7933536/
Abstract

The tumour microenvironment has been shown to be a valuable source of prognostic information for different cancer types. This holds in particular for triple negative breast cancer (TNBC), a breast cancer subtype for which currently no prognostic biomarkers are established. Although different methods to assess tumour infiltrating lymphocytes (TILs) have been published, it remains unclear which method (marker, region) yields the most optimal prognostic information. In addition, to date, no objective TILs assessment methods are available. For this proof of concept study, a subset of our previously described TNBC cohort (n = 94) was stained for CD3, CD8 and FOXP3 using multiplex immunohistochemistry and subsequently imaged by a multispectral imaging system. Advanced whole-slide image analysis algorithms, including convolutional neural networks (CNN) were used to register unmixed multispectral images and corresponding H&E sections, to segment the different tissue compartments (tumour, stroma) and to detect all individual positive lymphocytes. Densities of positive lymphocytes were analysed in different regions within the tumour and its neighbouring environment and correlated to relapse free survival (RFS) and overall survival (OS). We found that for all TILs markers the presence of a high density of positive cells correlated with an improved survival. None of the TILs markers was superior to the others. The results of TILs assessment in the various regions did not show marked differences between each other. The negative correlation between TILs and survival in our cohort are in line with previous studies. Our results provide directions for optimizing TILs assessment methodology.

摘要

肿瘤微环境已被证明是不同癌症类型有价值的预后信息来源。这尤其适用于三阴性乳腺癌(TNBC),这是一种目前尚无明确预后生物标志物的乳腺癌亚型。尽管已经发表了不同评估肿瘤浸润淋巴细胞(TILs)的方法,但仍不清楚哪种方法(标志物、区域)提供了最优化的预后信息。此外,迄今为止,还没有客观的 TILs 评估方法。在这项概念验证研究中,我们之前描述的 TNBC 队列的一部分(n=94)使用多重免疫组化染色了 CD3、CD8 和 FOXP3,并随后使用多光谱成像系统进行成像。先进的全幻灯片图像分析算法,包括卷积神经网络(CNN),用于注册未混合的多光谱图像和相应的 H&E 切片,分割不同的组织区室(肿瘤、基质)并检测所有单个阳性淋巴细胞。分析了肿瘤及其相邻环境中不同区域的阳性淋巴细胞密度,并将其与无复发生存率(RFS)和总生存率(OS)相关联。我们发现,对于所有 TILs 标志物,高浓度阳性细胞的存在与生存改善相关。没有一种 TILs 标志物优于其他标志物。各个区域的 TILs 评估结果彼此之间没有明显差异。我们队列中 TILs 与生存之间的负相关与之前的研究一致。我们的研究结果为优化 TILs 评估方法提供了方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/d3026d3ea71f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/40831214b61a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/0c717e67a820/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/74319d4d7753/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/ef1cec526d6b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/d3026d3ea71f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/40831214b61a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/0c717e67a820/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/74319d4d7753/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/ef1cec526d6b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32d/7933536/d3026d3ea71f/gr5.jpg

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本文引用的文献

[1]
Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer.

NPJ Breast Cancer. 2020-5-12

[2]
Histological subtypes in triple negative breast cancer are associated with specific information on survival.

Ann Diagn Pathol. 2020-6

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Deep learning and manual assessment show that the absolute mitotic count does not contain prognostic information in triple negative breast cancer.

Cell Oncol (Dordr). 2019-4-15

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Epithelium segmentation using deep learning in H&E-stained prostate specimens with immunohistochemistry as reference standard.

Sci Rep. 2019-1-29

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Tumor-Infiltrating Lymphocytes and Prognosis: A Pooled Individual Patient Analysis of Early-Stage Triple-Negative Breast Cancers.

J Clin Oncol. 2019-1-16

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International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study.

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Adv Anat Pathol. 2017-9

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Role of tumor microenvironment in tumorigenesis.

J Cancer. 2017-2-25

[9]
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Breast. 2017-3-28

[10]
Higher densities of Foxp3 regulatory T cells are associated with better prognosis in triple-negative breast cancer.

Breast Cancer Res Treat. 2017-5

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