Profile of immune cells in axillary lymph nodes predicts disease-free survival in breast cancer.
Profile of immune cells in axillary lymph nodes predicts disease-free survival in breast cancer.
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腋窝淋巴结中免疫细胞的特征可以预测乳腺癌中无疾病的生存。
DOI：
10.1371/journal.pmed.0020284
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发表时间：
2005-09
期刊：
影响因子：
15.8
通讯作者：
Lee, PP
中科院分区：
文献类型：
--
作者：
Kohrt, HE;Nouri, N;Nowels, K;Johnson, D;Holmes, S;Lee, PP
虽然淋巴结转移是乳腺癌患者无病生存和总体生存的最强预测因子之一，但肿瘤引流淋巴结的免疫学性质经常被忽视，可能为临床结果提供额外的预后信息。我们对77例乳腺癌患者的47个前哨淋巴结和104个腋窝（非前哨淋巴结）进行了免疫组织化学分析，随访5年，以确定CD4、CD8和CD1a细胞群的改变是否能预测淋巴结转移或无病生存。与对照淋巴结相比，乳腺癌患者前哨淋巴结和腋窝淋巴结CD4和CD8 T细胞减少。CD1a树突状细胞在前哨淋巴结和肿瘤累及的腋窝淋巴结中也减少，但在无肿瘤的腋窝淋巴结中增加。腋窝淋巴结，而不是前哨淋巴结，CD4 T细胞和树突状细胞数量与无病生存高度相关，独立于腋窝转移。来自48名患者的ALN免疫谱分析，应用CD4 T细胞和CD1a树突状细胞群阈值CD4≥7.0%和CD1a≥0.6%，从29名患者的学习集分析中确定，提供了显著的风险分层，分为有利和不利的预后组，优于临床病理特征，包括肿瘤大小，淋巴结转移的程度或大小（CD4, p < 0.001和CD1a， p < 0.001）。此外，腋窝淋巴结CD4 T细胞和CD1a树突状细胞群使得T1（原发肿瘤大小为2cm或以下）和T2 （5cm或更大）肿瘤患者的无病生存分层比所有其他患者特征更显著。最后，前哨淋巴结免疫谱主要与浸润性肿瘤细胞的存在相关，而腋窝淋巴结免疫谱似乎在很大程度上与淋巴结转移无关，这提出了在腋窝淋巴结内，免疫谱变化和淋巴结转移代表独立过程的可能性。这些发现表明，肿瘤引流淋巴结的免疫谱对早期乳腺癌患者具有新的生物学和临床意义。
While lymph node metastasis is among the strongest predictors of disease-free and overall survival for patients with breast cancer, the immunological nature of tumor-draining lymph nodes is often ignored, and may provide additional prognostic information on clinical outcome. We performed immunohistochemical analysis of 47 sentinel and 104 axillary (nonsentinel) nodes from 77 breast cancer patients with 5 y of follow-up to determine if alterations in CD4, CD8, and CD1a cell populations predict nodal metastasis or disease-free survival. Sentinel and axillary node CD4 and CD8 T cells were decreased in breast cancer patients compared to control nodes. CD1a dendritic cells were also diminished in sentinel and tumor-involved axillary nodes, but increased in tumor-free axillary nodes. Axillary node, but not sentinel node, CD4 T cell and dendritic cell populations were highly correlated with disease-free survival, independent of axillary metastasis. Immune profiling of ALN from a test set of 48 patients, applying CD4 T cell and CD1a dendritic cell population thresholds of CD4 ≥ 7.0% and CD1a ≥ 0.6%, determined from analysis of a learning set of 29 patients, provided significant risk stratification into favorable and unfavorable prognostic groups superior to clinicopathologic characteristics including tumor size, extent or size of nodal metastasis (CD4, p < 0.001 and CD1a, p < 0.001). Moreover, axillary node CD4 T cell and CD1a dendritic cell populations allowed more significant stratification of disease-free survival of patients with T1 (primary tumor size 2 cm or less) and T2 (5 cm or larger) tumors than all other patient characteristics. Finally, sentinel node immune profiles correlated primarily with the presence of infiltrating tumor cells, while axillary node immune profiles appeared largely independent of nodal metastases, raising the possibility that, within axillary lymph nodes, immune profile changes and nodal metastases represent independent processes. These findings demonstrate that the immune profile of tumor-draining lymph nodes is of novel biologic and clinical importance for patients with early stage breast cancer.
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影响因子：
8.8
作者：
通讯作者：
--
影响因子：
4.4
作者：
Laguens, G;Coronato, S;Di Girolamo, V
通讯作者：
Di Girolamo, V
影响因子：
4.4
作者：
Liyanage, UK;Moore, TT;Linehan, DC
通讯作者：
Linehan, DC
DOI：
10.1186/bcr808
发表时间：
2004
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Poindexter NJ;Sahin A;Hunt KK;Grimm EA
通讯作者：
Grimm EA
影响因子：
4.4
作者：
ALAM, SM;CLARK, JS;CAMPBELL, AM
通讯作者：
CAMPBELL, AM