Tumor-infiltrating lymphocytes are important pathologic predictors for neoadjuvant chemotherapy in patients with breast cancer |
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| Authors: | Yamaguchi Rin Tanaka Maki Yano Ayako Tse Gary M Yamaguchi Miki Koura Keiko Kanomata Naoki Kawaguchi Atsushi Akiba Jun Naito Yoshiki Ohshima Koichi Yano Hirohisa |
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| Affiliation: | a Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japanb Department of Pathology and Laboratory Medicine, Kurume University Medical Center, Kurume, Fukuoka, Japanc Department of Surgery, Social Insurance Kurume Daiichi Hospital, Kurume, Fukuoka, Japand Department of Clinical Research Center, Social Insurance Kurume Daiichi Hospital, Kurume, Fukuoka, Japane Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kongf Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japang Department of Biostatistics Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan |
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| 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. |
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| Keywords: | Tumor-infiltrating lymphocytes Breast cancer Histological grade HER2 Neoadjuvant therapy Pathologic complete response |
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