Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan.
Breast Cancer Res. 2022 Oct 10;24(1):67. doi: 10.1186/s13058-022-01563-7.
Rating lymphocytes (TILs) are a prognostic marker in breast cancer and high TIL infiltration correlates with better patient outcomes. Meanwhile, parameters involving immune cells in peripheral blood have also been established as prognostic markers. High platelet-to-lymphocyte ratios (PLRs) and neutrophil-to-lymphocyte ratios (NLRs) are related to poor outcomes in breast cancer, but their mechanisms remain unknown. To date, TILs and these parameters have been examined separately.
We investigated the relationship between TILs and the peripheral blood markers, PLR and NLR, in the same patients, using surgical specimens from 502 patients with invasive breast carcinoma without preoperative chemotherapy. For analysis of triple-negative breast cancer (TNBC) patient outcomes, 59 patients who received preoperative chemotherapy were also examined. For immune cell profiling, multiplexed fluorescent immunohistochemistry (mfIHC) of CD3, CD4, CD8, FOXP3 and T-bet, was conducted.
A positive correlation between PLR and TIL was observed in TNBC (P = 0.013). On mfIHC, tumors in patients with high PLR and NLR contained more CD3CD4FOXP3 T-cells (P = 0.049 and 0.019, respectively), while no trend was observed in CD8 T-cells. TNBC patients had different patterns of outcomes according to TIL and PLR, with the TIL-high/PLR-low group having the lowest rate of disease relapse and death, and the longest distant metastasis-free and overall survivals, while the TIL-low/PLR-high group had the shortest survivals.
Our data suggest that the combination of PLR with TIL assessment may enable more accurate prediction of patient outcomes with TNBC.
在乳腺癌中，评分淋巴细胞（TILs）是一种预后标志物，高 TIL 浸润与患者更好的预后相关。同时，外周血中涉及免疫细胞的参数也被确立为预后标志物。高血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）与乳腺癌不良预后相关，但具体机制尚不清楚。迄今为止，TILs 和这些参数都是分别进行研究的。
我们使用 502 例未经术前化疗的浸润性乳腺癌患者的手术标本，研究了 TILs 与外周血标志物 PLR 和 NLR 之间的关系。为了分析三阴性乳腺癌（TNBC）患者的结局，还检查了 59 例接受术前化疗的患者。为了进行免疫细胞分析，进行了 CD3、CD4、CD8、FOXP3 和 T-bet 的多重荧光免疫组化（mfIHC）。
在 TNBC 中观察到 PLR 与 TIL 呈正相关（P = 0.013）。在 mfIHC 中，PLR 和 NLR 高的患者肿瘤中含有更多的 CD3CD4FOXP3 T 细胞（P = 0.049 和 0.019），而 CD8 T 细胞则没有这种趋势。根据 TIL 和 PLR，TNBC 患者的结局模式不同，TIL 高/PLR 低组疾病复发和死亡的发生率最低，无远处转移和总生存期最长，而 TIL 低/PLR 高组的生存期最短。
我们的数据表明，PLR 与 TIL 评估相结合可能能够更准确地预测 TNBC 患者的结局。
