Down-regulation of the CD3-zeta chain in sentinel node biopsies from breast cancer patients.
BACKGROUND
In several neoplastic diseases, immunosuppression has been shown to correlate with disease stage, progression, and outcome. As the prognosis for metastatic breast cancer is still pessimistic, additional strategies are being sought to improve survival. Local immunosuppression in sentinel node biopsies from 24 evaluable breast cancer patients was studied as a possible way of selecting patients for immunotherapy.


METHODS
Sentinel node biopsy was performed in 24 out of 25 women operated on for primary breast cancer (one was not evaluable). Specimens were snap-frozen and double-stained for the zeta-chain of the T-cell receptor. The degree of down-regulation of the zeta-chain was evaluated in three different lymph-node areas: primary follicles, secondary follicles, and paracortex.


RESULTS
Down-regulation of varying degrees was noted in all 24 sentinel node biopsies. A high degree of down-regulation (more than 50% of T-cells not expressing zeta-chain) was seen in the primary follicles in six patients (25%), in the secondary follicles in 13 patients (72%), and in the paracortex in 19 patients (79%).


CONCLUSIONS
Local down-regulation of an immune function parameter was seen in sentinel node biopsies from breast cancer patients. In addition to possible prognostic implications, the sentinel node might be an appropriate location for detecting early-stage immunological down-regulation, which might open a possibility of selecting patients who could benefit from immunotherapy.
Schüle
Jana
J
Department of Surgery, Central Hospital, Västerås, Sweden.
Bergkvist
Leif
L
Håkansson
Leif
L
Gustafsson
Bertil
B
Håkansson
Annika
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000276:immunology* / Q000473:pathology*; D017252:CD3 Complex / Q000032:analysis / Q000096:biosynthesis* / Q000276:immunology*; D015536:Down-Regulation; D005260:Female; D006801:Humans; D007167:Immunotherapy; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy
D017252:CD3 Complex; C121704:CD3 antigen, zeta chain