Prognostic value of tumor‑infiltrating lymphocytes in estrogen receptor‑positive and human epidermal growth factor receptor 2‑negative breast cancer

Honda,Chikako; Kurozumi,Sasagu; Katayama,Ayaka; Hanna‑Khalil,Bishoy; Masuda,Kei; Nakazawa,Yuko; Ogino,Misato; Obayashi,Sayaka; Yajima,Reina; Makiguchi,Takaya; Oyama,Tetsunari; Horiguchi,Jun; Shirabe,Ken; Fujii,Takaaki

doi:10.3892/mco.2021.2414

Prognostic value of tumor‑infiltrating lymphocytes in estrogen receptor‑positive and human epidermal growth factor receptor 2‑negative breast cancer

Authors:
- Chikako Honda
- Sasagu Kurozumi
- Ayaka Katayama
- Bishoy Hanna‑Khalil
- Kei Masuda
- Yuko Nakazawa
- Misato Ogino
- Sayaka Obayashi
- Reina Yajima
- Takaya Makiguchi
- Tetsunari Oyama
- Jun Horiguchi
- Ken Shirabe
- Takaaki Fujii
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Affiliations: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371‑8511, Japan, Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma 371‑8511, Japan, School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK, Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371‑8511, Japan, Department of Breast Surgery, International University of Health and Welfare, Chiba 286‑8520, Japan
Published online on: October 8, 2021 https://doi.org/10.3892/mco.2021.2414
Article Number: 252
Copyright: © Honda et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Tumor‑infiltrating lymphocytes (TILs) are a significant prognostic factor in triple‑negative breast cancer. However, the clinicopathological significance of TILs in estrogen receptor (ER)‑positive and human epidermal growth factor receptor 2 (HER2)‑negative breast cancer remains unclear. The purpose of the present study was to evaluate the role of TILs in the prognosis of ER‑positive and HER2‑negative breast cancer. A total of 65 consecutive patients with ER‑positive and HER2‑negative breast cancer were examined. TILs in stromal tissue (str‑TILs) were graded using the International TILs Working Group criteria. The association between several clinicopathological factors and TIL grade were investigated, and the prognostic impact of TILs was compared between luminal A‑like and luminal B‑like breast cancer. A total of 51 patients (78.5%) had low‑grade (0‑10%), 11 (16.9%) had intermediate (10‑40%) and 3 (4.6%) had high‑grade (40‑90%) str‑TIL levels. There was a significant association between high levels of Ki67 expression and a high str‑TIL count. Relapse‑free survival was significantly worse in patients with luminal B‑like cancer compared with that in patients with luminal A‑like cancer. Patients with an intermediate or high str‑TIL count had a better prognosis compared with those with a low str‑TIL count. All patients with luminal B‑like cancer and intermediate or high str‑TIL levels developed no recurrence during follow‑up. In conclusion, there was a significant correlation between high‑grade str‑TIL levels and high tumor cell proliferation rate, as well as high levels of Ki67 expression.

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