Prognostic value of tumor‑infiltrating lymphocytes in estrogen receptor‑positive and human epidermal growth factor receptor 2‑negative breast cancer

Abstract

Tumor-infiltrating lymphocytes (TILs) are a significant prognostic factor in triple-negative breast cancer. However, the clinicopathological significance of TILs in estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer remains unclear. The purpose of the present study was to evaluate the role of TILs in the prognosis of ER-positive and HER2-negative breast cancer. A total of 65 consecutive patients with ER-positive and HER2-negative breast cancer were examined. TILs in stromal tissue (str-TILs) were graded using the International TILs Working Group criteria. The association between several clinicopathological factors and TIL grade were investigated, and the prognostic impact of TILs was compared between luminal A-like and luminal B-like breast cancer. A total of 51 patients (78.5%) had low-grade (0-10%), 11 (16.9%) had intermediate (10-40%) and 3 (4.6%) had high-grade (40-90%) str-TIL levels. There was a significant association between high levels of Ki67 expression and a high str-TIL count. Relapse-free survival was significantly worse in patients with luminal B-like cancer compared with that in patients with luminal A-like cancer. Patients with an intermediate or high str-TIL count had a better prognosis compared with those with a low str-TIL count. All patients with luminal B-like cancer and intermediate or high str-TIL levels developed no recurrence during follow-up. In conclusion, there was a significant correlation between high-grade str-TIL levels and high tumor cell proliferation rate, as well as high levels of Ki67 expression.

The Impact of Tumor Infiltrating Lymphocytes Densities and Ki67 Index on Residual Breast Cancer Burden following Neoadjuvant Chemotherapy

“…For luminal-HER2 negative included cases, TILs do not appear to have a significant correlation with pCR, as has been found in many previous studies [30,31] and in a meta-analysis performed by Gao and his colleagues [32]. In contrary to the findings of most of the reviewed studies, we were unable to find a significant association between TILs and pCR in TNBC [33,34].…”

“…In regard to the relationship between tumor-infiltrating CD20 B cells and neoadjuvant chemotherapy, previous studies were inconclusive [ 29 , 30 ]. Some studies found that the mean of CD20 B cells in tumors was not significantly associated with chemotherapy effect [ 31 , 32 ]. However, a link has been found between B cell infiltration and poor prognosis in a recent clinical study [ 39 ].…”

Prognostic Relevance of Nuclear Receptors in Relation to Peritumoral Inflammation and Tumor Infiltration by Lymphocytes in Breast Cancer

“…We then analyzed the influence of the peritumoral infiltrate on the prognostic value of nuclear receptors. Although the prognostic value of TIL levels in the ER-negative/Her2-negative breast cancer population is well known, the impact of immune infiltration on the prognosis value of NRs was never investigated before [ 53 , 54 , 55 ]. ERα (and steroid hormone receptor expression in general) is known to be favorable concerning OS [ 56 , 57 , 58 ] in BC.…”

One Step Nucleic Acid Amplification (OSNA) Lysate Samples Are Suitable to Establish a Transcriptional Metastatic Signature in Patients with Early Stage Hormone Receptors-Positive Breast Cancer

“…Stromal TILs were quantified on hematoxylin and eosin sections of tumor according to the guidelines of the International TILs Working Group [ 41 ]. The stromal TILs count was categorized into three grades: low (0–10%), intermediate (10–40%), or high (40–90%) [ 41 , 42 ].…”