Vernet-Tomas Maria, Vazquez Ivonne, Olivares Francesc, Lopez David, Yelamos Jose, Comerma Laura
Breast Diseases Unit, Hospital Del Mar, Barcelona, Spain.
Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
Breast Cancer (Dove Med Press). 2024 Oct 5;16:657-666. doi: 10.2147/BCTT.S476721. eCollection 2024.
The aim of this study was to determine whether low HLA-I expression and NK cells infiltration are related to prognostic features in breast cancer, as observed in cancers in other locations and non-hormone dependent breast cancers. Particularly, we explored their relation to infiltrated axillary lymph nodes (ALNs), with the aim of finding new predictors helping to decide the extent of axillary surgery.
We conducted a retrospective correlational analysis of 35 breast cancers from 35 breast cancer patients showing axillary infiltration at diagnosis and with upfront surgery. HLA-I H-score and the number of NK cells x 50 high power fields (HPF) in the biopsy specimen were correlated with pathological variables of the surgical specimen: number of infiltrated ALNs, tumor size, histological type, the presence of ductal carcinoma in situ, focality, histological grade, necrosis, lymphovascular and perineural invasion, Her2Neu status, and the percentages of tumor-infiltrating lymphocytes (TILs), estrogen receptor, progesterone receptor, ki67, and p53.
All tumors showed hormone receptor expression and three of them Her2Neu positivity. A positive correlation (p=0.001**) was found between HLA-I H-score and TILs and Ki67 expression. HLA H-score increased with histological grade and was higher in unifocal than in multifocal disease (p=0.044 and p=0.011, respectively). No other correlations were found.
High HLA-I H-score values correlated with features of poor prognosis in this cohort of luminal breast tumors, but not with infiltrated ALNs. This finding highlights the differences between luminal breast cancer, and cancers in other locations and non-hormone dependent breast cancers, in which low HLA-I expression tends to be associated with poor prognostic features.
本研究旨在确定低HLA-I表达和自然杀伤（NK）细胞浸润是否与乳腺癌的预后特征相关，正如在其他部位癌症和非激素依赖性乳腺癌中所观察到的那样。特别是，我们探讨了它们与腋窝淋巴结转移（ALNs）的关系，旨在寻找有助于确定腋窝手术范围的新预测指标。
我们对35例乳腺癌患者的35例乳腺癌进行了回顾性相关性分析，这些患者在诊断时显示腋窝浸润并接受了前期手术。活检标本中的HLA-I H评分和NK细胞数量×50高倍视野（HPF）与手术标本的病理变量相关：腋窝淋巴结转移数量、肿瘤大小、组织学类型、原位导管癌的存在、灶性、组织学分级、坏死、淋巴管和神经周围浸润、Her2Neu状态，以及肿瘤浸润淋巴细胞（TILs）、雌激素受体、孕激素受体、ki67和p53的百分比。
所有肿瘤均显示激素受体表达，其中3例为Her2Neu阳性。发现HLA-I H评分与TILs和Ki67表达之间存在正相关（p = 0.001**）。HLA H评分随组织学分级增加，单灶性疾病中的评分高于多灶性疾病（分别为p = 0.044和p = 0.011）。未发现其他相关性。
在这一管腔型乳腺肿瘤队列中，高HLA-I H评分值与预后不良特征相关，但与腋窝淋巴结转移无关。这一发现突出了管腔型乳腺癌与其他部位癌症和非激素依赖性乳腺癌之间的差异，在其他部位癌症和非激素依赖性乳腺癌中，低HLA-I表达往往与预后不良特征相关。
