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评估浸润性乳腺癌分子亚型中基质肿瘤浸润淋巴细胞与雄激素受体表达之间的临床病理关系。

Evaluating the Clinico-Pathological Relationship Between Stromal Tumor-Infiltrating Lymphocytes and Androgen Receptor Expression Across Molecular Subtypes of Invasive Breast Carcinoma.

作者信息

Khan Adil Aziz, Ahuja Sana, G Kiruthikasri, Zaheer Sufian

机构信息

Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

出版信息

Indian J Surg Oncol. 2024 Dec;15(4):802-808. doi: 10.1007/s13193-024-02001-0. Epub 2024 Jun 27.

Abstract

Breast cancer remains a significant cause of mortality globally, necessitating effective treatment strategies. Neoadjuvant chemotherapy (NAC) is widely employed to minimize tumor burden and prevent local spread, with treatment efficacy varying based on molecular subtypes. Despite advancements, resistance to conventional therapies persists, prompting the exploration of alternative approaches, including immune cell therapy. Tumor-infiltrating lymphocytes (TILs) have emerged as immunological biomarkers in breast cancer, exhibiting associations with molecular subtypes and treatment response. This retrospective study assessed the clinico-pathological relationship between stromal TILs and AR expression across molecular subtypes of invasive breast carcinoma in an Indian cohort. Thirty-seven patients receiving NAC followed by modified radical mastectomy were analyzed for TILs and molecular subtyping. Immunohistochemistry was used to determine hormone receptor status and AR expression. A higher AR positivity was observed in hormone receptor-positive/Her2neu-negative and hormone receptor-positive/Her2neu-positive tumors compared to triple-negative breast cancers (TNBCs). Significant associations were observed between AR expression and tumor grade, but not with age or Her2neu status. Although no significant correlation was found between AR and complete response to NAC, a weak negative correlation between AR and TILs was noted. Notably, TNBCs with negative AR and Ki67 index exhibited poorer responses to NAC, emphasizing the need for adjuvant therapy. These findings underscore the complex interplay between AR, TILs, and treatment response in breast cancer, highlighting the potential of personalized therapeutic approaches. Further research is warranted to elucidate the prognostic significance of AR and its implications for tailored treatment strategies in breast cancer management.

摘要

乳腺癌仍然是全球范围内导致死亡的重要原因,因此需要有效的治疗策略。新辅助化疗(NAC)被广泛应用以减轻肿瘤负荷并防止局部扩散,其治疗效果因分子亚型而异。尽管取得了进展,但对传统疗法的耐药性仍然存在,这促使人们探索包括免疫细胞疗法在内的替代方法。肿瘤浸润淋巴细胞(TILs)已成为乳腺癌中的免疫生物标志物,与分子亚型和治疗反应相关。这项回顾性研究评估了印度队列中浸润性乳腺癌分子亚型间基质TILs与AR表达之间的临床病理关系。对37例接受NAC后行改良根治性乳房切除术的患者进行了TILs和分子亚型分析。采用免疫组织化学法确定激素受体状态和AR表达。与三阴性乳腺癌(TNBC)相比,激素受体阳性/Her2neu阴性和激素受体阳性/Her2neu阳性肿瘤中观察到更高的AR阳性率。AR表达与肿瘤分级之间存在显著相关性,但与年龄或Her2neu状态无关。虽然未发现AR与NAC的完全缓解之间存在显著相关性,但注意到AR与TILs之间存在弱负相关。值得注意的是,AR和Ki67指数均为阴性的TNBC对NAC的反应较差,这强调了辅助治疗的必要性。这些发现强调了AR、TILs和乳腺癌治疗反应之间复杂的相互作用,突出了个性化治疗方法的潜力。有必要进一步研究以阐明AR的预后意义及其对乳腺癌管理中定制治疗策略的影响。

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