title: Gains and losses of HLA class II (DR) and CD4 in atypical hyperplasia, carcinoma in situ and infiltrating ductal carcinoma of the breast.
abstract: OBJECTIVE
  Breast cancer is a frequent cause of death among women with gynaecologic malignancies despite the introduction of combination chemotherapy. There is therefore a need for new therapeutic strategies for patients with breast cancer, such as cellular immunotherapy. In this immunohistochemical study we analyzed the epithelial expression of major histocompatibility complex (MHC) class II (HLA-DR) on atypical and malignant primary mammary epithelial cells, as well as the magnitude of the stromal T lymphocytes (T4 subset) at the tumor site.
  
  
  METHODS
  The study was carried out retrospectively in tumor tissue from 82 patients with mammary lesions (31 cases of atypical ductal hyperplasia -ADH-, 12 cases of ductal carcinoma in situ -DCIS- and 39 cases of infiltrating ductal carcinoma not otherwise specified -IDC-NOS). Medullary carcinomas were not included in our investigation. Material used had been formalin fixed and paraffin embedded.
  
  
  RESULTS
  HLA class II (DR) was expressed in 20 of 31 ADHs (64.5%), in 4 of 12 DCISs (33.3%), and in 10 of 39 IDC-NOSs (25.6%). CD4 was expressed in 9 of 31 ADHs (29%), in 5 of 12 DCISs (42%), and in 26 of 39 IDC-NOSs (67%).
  
  
  CONCLUSIONS
  The results showed decreased epithelial expression of HLA class II (DR) and increased stromal expression of CD4, as the lesion progressed to malignancy. Gradual loss of epithelial HLA class II expression might be a manifestation of cellular differentiation from the atypical form versus the malignant one, signaling simultaneously a selective effect on the response capacity of the immune system.
authors.affiliation: Department of Cytology, General Hospital of Chania.
authors.forename: Demetrio
authors.initials: D
authors.lastname: Tamiolakisl
authors.forename: Ioannis
authors.initials: I
authors.lastname: Venizelos
authors.forename: Maria
authors.initials: M
authors.lastname: Lambropoulou
authors.forename: Theodoros
authors.initials: T
authors.lastname: Jivannakis
authors.forename: Evagelia
authors.initials: E
authors.lastname: Seliniotakis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsikouras
authors.forename: Vasilios
authors.initials: V
authors.lastname: Limberis
authors.forename: Angelos
authors.initials: A
authors.lastname: Tsalkidis
authors.forename: Nikolas
authors.initials: N
authors.lastname: Papadopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000276:immunology*; D015704:CD4 Antigens / Q000032:analysis; D018791:CD4 Lymphocyte Count; D018270:Carcinoma, Ductal, Breast / Q000276:immunology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000276:immunology*; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D006965:Hyperplasia / Q000276:immunology; D008875:Middle Aged
chemical_list: D015704:CD4 Antigens; D006684:HLA-DR Antigens