title: Tumor-infiltrating lymphocytes are important pathologic predictors for neoadjuvant chemotherapy in patients with breast cancer.
abstract: Neoadjuvant chemotherapy or preoperative systemic therapy is increasingly considered for patients with operable breast cancer. Patients with breast cancer were examined for pathologic factors predictive of response to neoadjuvant chemotherapy, using an anthracycline-based regimen. For clinical histomorphology and biomarkers, factors were compared among 16 pathologically complete responses and 52 nonpathologically complete responses, using univariate analysis and multivariate regression analysis of principal components, using preneoadjuvant chemotherapy needle biopsy samples as follows: degree of tumor-infiltrating lymphocytes, histologic grade, biology-based tumor type (hormone receptors and HER2 [human epidermal growth factor receptor type 2]), age, clinical TNM stage, and TNM staging. In univariate analysis, high tumor-infiltrating lymphocyte, high histologic grade, and hormone receptors(-)/HER2(+) were significantly associated with pathologically complete responses (93.7%, P < .0001; 81.3%, P = .0206; 43.7%, P = .014, respectively). In multivariate principal component regression analysis, high tumor-infiltrating lymphocytes were the best independent predictor for pathologically complete responses (odds ratio, 4.7; confidence interval, 2.2-10.06; P < .0001). Among tumor-infiltrating lymphocytes and biology-based tumor types, patients with high tumor-infiltrating lymphocytes had pathologically complete responses more than nonpathologically complete responses, especially in the hormone receptors(-)/HER2(+) group. Among high tumor-infiltrating lymphocyte cases, T lymphocytes showed more predominant tendency than B lymphocytes in the pathologically complete responses cases, compared with nonpathologically complete responses cases. These findings indicate that high tumor-infiltrating lymphocytes are important predictors of pathologically complete responses to neoadjuvant chemotherapy, especially in the hormone receptors(-)/HER2(+) group.
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan. rin@med.kurume-u.ac.jp
authors.forename: Rin
authors.initials: R
authors.lastname: Yamaguchi
authors.forename: Maki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Ayako
authors.initials: A
authors.lastname: Yano
authors.forename: Gary M
authors.initials: GM
authors.lastname: Tse
authors.forename: Miki
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Koura
authors.forename: Naoki
authors.initials: N
authors.lastname: Kanomata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Jun
authors.initials: J
authors.lastname: Akiba
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Naito
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yano
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001402:B-Lymphocytes / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D025341:Principal Component Analysis; D013601:T-Lymphocytes / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents