Sentinel lymph node B cells can predict disease-free survival in breast cancer patients
Sentinel lymph node B cells can predict disease-free survival in breast cancer patients
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DOI：
10.1038/s41523-018-0081-7
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发表时间：
2018-08-23
影响因子：
5.9
通讯作者：
Lee, Peter P.
中科院分区：
文献类型：
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作者：
Blenman, Kim R. M.;He, Ting-Fang;Lee, Peter P.
作为TNM分期系统的一部分，肿瘤浸润引流淋巴结，特别是前哨淋巴结（SLN）是乳腺癌预后和治疗的关键决定因素。我们使用免疫组织学和定量图像分析，从76例乳腺癌患者的发现队列中定量SLN内的免疫细胞。我们发现，肿瘤阴性淋巴结中原位CD 3（+）T细胞在统计学上多于肿瘤阳性淋巴结（平均值分别为8878 vs. 6704，p = 0.006），但CD 20（+）B细胞或CD 1a（+）树突状细胞无统计学差异。在单变量分析中，观察到风险降低，log CD 3单位增加HR 0.49（95% CI 0.30-0.80），log CD 20单位增加HR 0.37（95% CI 0.22-0.62）。在多变量分析中，log CD 20保持显著性，HR 0.42（95% CI 0.25-0.69）。当仅限于SLN肿瘤阴性患者时，log CD 20增加仍与DFS改善相关（HR = 0.26，95% CI 0.08-0.90）。CD 20结果在21名SLN阴性三阴性乳腺癌（TNBC）患者（n = 11名结局良好，n = 10名结局不良）的单独队列中得到验证（“良好”平均值为7011，“不良”平均值为4656，p = 0.002）。我们的研究表明，分析SLN内的免疫细胞，无论肿瘤的侵袭状态如何，都可以提供额外的预后信息，并强调SLN内的B细胞在预防未来复发中的重要性。
Tumor invasion into draining lymph nodes, especially sentinel lymph nodes (SLNs), is a key determinant of prognosis and treatment in breast cancer as part of the TNM staging system. Using multicolor histology and quantitative image analysis, we quantified immune cells within SLNs from a discovery cohort of 76 breast cancer patients. We found statistically more in situ CD3(+) T cells in tumor negative vs. tumor positive nodes (mean of 8878 vs. 6704, respectively, p = 0.006), but no statistical difference in CD20(+) B cells or CD1a(+) dendritic cells. In univariate analysis, a reduced hazard was seen with a unit increase in log CD3 with HR 0.49 (95% CI 0.30-0.80) and log CD20 with HR 0.37 (95% CI 0.22-0.62). In multivariate analysis, log CD20 remained significant with HR 0.42 (95% CI 0.25-0.69). When restricted to SLN tumor negative patients, increased log CD20 was still associated with improved DFS (HR = 0.26, 95% CI 0.08-0.90). The CD20 results were validated in a separate cohort of 21 patients (n = 11 good outcome, n = 10 poor outcome) with SLN negative triple-negative breast cancer (TNBC) ("good" mean of 7011 vs. "poor" mean of 4656, p = 0.002). Our study demonstrates that analysis of immune cells within SLNs, regardless of tumor invasion status, may provide additional prognostic information, and highlights B cells within SLNs as important in preventing future recurrence.