The prognostic significance of B lymphocytes in invasive carcinoma of the breast

Abstract

Although the favourable role of T lymphocyte populations in different tumour types is established, that of B cells is still a matter of debate and needs further clarification. The presence of tumour-infiltrating B cells may represent an antibody response against breast tumour antigens. We used immunohistochemistry to investigate the density and localisation of B lymphocytes infiltrating 1470 breast tumours and to identify any prognostic significance and relationship to various clinicopathological factors. Higher numbers of CD20(+) cells were found in the stroma away from the carcinoma (mean 12 cells) compared with either intratumoural or adjacent stromal compartments (mean 1 cell). The majority of tumours showed a diffuse pattern of B cells rather than aggregates. There was a positive correlation between higher numbers of total CD20(+) B cells and higher tumour grade (r (s) = 0.20, P < 0.001), ER and PgR negativity (P < 0.001), and basal phenotype (P < 0.001) subclass. In univariate survival analysis, higher total number of infiltrating CD20(+) cells, irrespective of location, was associated with significantly better BCSS (P = 0.037) and longer DFI (P = 0.001). In multivariate analysis, total CD20(+) B cell count (HR = 0.75, 95% CI = 0.58-0.96 for BCSS and HR = 0.72, 95% CI = 0.58-0.89, for DFI), tumour size, nodal stage, grade, vascular invasion, HER-2 status, and total CD8(+) T cell count were independently associated with outcome. This suggests that humoral immunity, in addition to the cell mediated immunity, may be important in breast cancer. This should be considered in breast cancer immunotherapy and vaccine strategies.

Tumor infiltration by Tbet+ effector T cells and CD20+ B cells is associated with survival in gastric cancer patients

“…CD20 C B cells contribute both to humoral immunity as antibody-producing cells, but also to cellular immunity by serving as antigen-presenting cells (APCs) and/or by providing costimulatory signals to T cells. 19,20 A favorable effect of tumor-infiltrating B cells on patient prognosis was previously reported in cutaneous melanoma, 21 breast cancer 22 and ovarian cancer, 23 but the mechanism linking the accumulation of these cells in the tumor microenvironment and better prognosis remains poorly understood. Nielsen et al found that tumor-infiltrating B cells expressed markers of antigen presentation and could have a function of professional APCs to support the T cell-mediated immune anticancer response.…”

Interrogation of individual intratumoral B lymphocytes from lung cancer patients for molecular target discovery

“…However, the presence of intratumoral B lymphocytes is associated with increased survival in several types of cancers, including non-small cell lung cancer (NSCLC) [10][11][12] and others [13][14][15][16], suggestive of anti-tumorigenic effects. These effects may at least be partly target specific.…”

Clinical and Biological Implications of the Tumor Microenvironment

“…On the other hand, CD8(+) T cells are a known active component of cell mediated immunity and a recent histopathological study of 1,334 breast cancer patients [60] has provided some support for a link between better survival and the total lymphocyte count in the tumor and in the surrounding tissues. Higher peri-tumoral B lymphocyte counts were also associated with better prognosis, but the numbers cited were not impressively high (12 cells per field) and the intra-tumoral content was found to be unrelated [61]. However, the same authors found no evidence for an association of prognosis with intra-tumoral FOXP3 regulatory T cells [62] and so the role (if any) of inflammatory cells in human cancer remains unconfirmed although potentially contributory to progression in some circumstances and to regression in others.…”