Immunohistochemical analysis of tumor-infiltrating lymphocytes in breast carcinoma: relation to prognostic variables.
BACKGROUND
The role of the tumor-infiltrating lymphocytes in invasive breast cancer and its correlation with different prognostic variables were always a matter of controversy in the literature.


OBJECTIVE
To determine the relative density of T lymphocytes, CD4+ cells, CD8+ cells, and B lymphocytes in breast cancer and assess their relationships with clinicopathologic parameters.


METHODS
Paraffin-embedded tissue sections from 48 invasive ductal carcinomas and 30 benign breast lesions were examined by means of immunohistochemistry to demonstrate CD3+, CD4+, CD8+, and CD20+. The immunophenotyped cells were semi-quantitatively graded into: Absent, intermediate, and extensive.


RESULTS
All lymphocyte populations were significantly more expressed in breast carcinomas than in benign lesions (P = 0.0001 for CD3+ and CD4+, P = 0.001 for CD8+, and P = 0.002 for CD20+ cells). In breast carcinoma, B and T cells were co-expressed in 33 of 48 tumors (68.8%). However, T cells were the predominant immunophenotype being noted in 81% of tumors, compared to B cells which were expressed in 50% of tumors. T cells, CD4+ and CD8+ cells were directly associated with patient's age (P = 0.004, P = 0.001, and P = 0.01, respectively). Clinical stages III and IV showed a significantly higher density of T and CD4+ lymphocytes than stage II (P = 0.004 and P = 0.009, respectively). Also, T and CD4+ cells were directly related to the histologic grade (P = 0.004 and P = 0.001, respectively). On the contrary, B lymphocytes were not related to any of the above-mentioned parameters.


CONCLUSIONS
Although B and T lymphocytes were co-expressed in breast cancer, T lymphocytes and their subpopulations seem to have the upper hand in predicting the biological behavior. They probably promote neoplastic progression rather than acting as an antitumor immune response.
Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Thanaa E A
TE
Helal
Eman A A
EA
Ibrahim
Amal I A
AI
Alloub
D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000276:immunology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology*; D044584:Carcinoma, Ductal / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D016131:Lymphocyte Subsets / Q000276:immunology*; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology