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Changes of Tumor Infiltrating Lymphocytes after Core Needle Biopsy and the Prognostic Implications in Early Stage Breast Cancer: A Retrospective Study

Cancer Research and Treatment 2019년 51권 4호 p.1336 ~ 1346
 ( Huang Jiahui ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center

 ( Chen Xiaosong ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center
 ( Fei Xiaochun ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Department of Pathology
 ( Huang Ou ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center
 ( Wu Jiayi ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center
 ( Zhu Li ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center
 ( He Jianrong ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center
 ( Chen Weiguo ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center
 ( Li Yafen ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center
 ( Shen Kunwei ) - Shanghai Jiao Tong University School of Medicine Ruijin Hospital Comprehensive Breast Health Center

Abstract


Purpose: The purpose of this study was to investigate the changes of tumor infiltrating lymphocytes (TILs) between core needle biopsy (CNB) and surgery removed sample (SRS) in early stage breast cancer patients and to identify the correlating factors and prognostic significance of TILs changes.

Materials and Methods: A retrospective study was carried out on 255 patients who received CNB and underwent surgical resection for invasive breast cancer. Stromal TILs levels of CNB and SRS were evaluated respectively. Tumors with ≥50% stromal TILs were defined as lymphocyte-predominant breast cancer (LPBC). Clinicopathological variables were analyzed to determine whether there were factors associated with TILs changes. Log-rank tests and Cox proportional hazards models were used to analyze the influences of TILs and TILs changes on survival.

Results: SRS-TILs (median, 10.0%) were significant higher than CNB-TILs (median, 5.0%; p<0.001). Younger age (<60 years, p=0.016) and long surgery time interval (STI, ≥4 days; p=0.003) were independent factors correlating with higher TILs changes. CNB-LPBC patients showed better breast cancer-free interval (BCFI, p=0.021) than CNB-non-LPBC (CNB-nLPBC) patients. Patients were categorized into four groups according to the LPBC change pattern from CNB to SRS: LPBC→LPBC, LPBC→nLPBC, nLPBC→LPBC, and nLPBC→nLPBC, with estimated 5-year BCFI 100%, 100%, 69.7%, and 86.0% (p=0.016). nLPBC→LPBC pattern was an independent prognostic factor of worse BCFI (hazard ratio, 2.19; 95% confidence interval, 1.06 to 4.53; p=0.035) compared with other patterns.

Conclusion: TILs were significantly higher in SRS than in CNB. Higher TILs changes were associated with younger age and long STI. Changing from nLPBC to LPBC after CNB indicated a worse BCFI, which needs further validation.

키워드

Breast neoplasms; Core needle biopsy; Surgery; Tumor infiltrating lymphocytes; Prognosis
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