Immunoarchitectural patterns as potential prognostic factors for invasive ductal breast cancer

Abstract

Currently, tumor-infiltrating lymphocytes (TILs) in invasive breast cancers are assessed solely on the basis of their number, whereas their spatial distribution is rarely investigated. Therefore, we evaluated TILs in 579 patients with invasive breast cancer of no special type (IBC-NST) with a focus on their spatial distributions in tumor center (TC) and invasive margin (IM). We also assessed a new factor, namely para-tumor infiltrating lymphocytes (PILs) in the para-tumor lobular area (Para). Five immunoarchitectural patterns (IPs) were observed, which were significantly associated with clinicopathological features, especially molecular subtypes, histological grades, clinical stages, and programmed death-ligand 1 (PD-L1) expression. High-TIL density (IP1/2) correlated with favorable disease-free survival (DFS) in TNBC patients (p = 0.04), but opposite results were observed for luminal B subtype patients (both the lowest TIL and PIL densities (IP5) correlated with good DFS, p = 0.013). Luminal B patients with high TILs in the IM and low TILs in the TC (IP3) exhibited the worst DFS, whereas those with low TILs (similar to IP5) and high PILs (IP4) exhibited poor DFS. We also identified TIL subpopulations with significantly different IPs. Our findings suggest that IP can be a potential prognostic factor for tumor immunity in IBC.

Artificial intelligence for quantifying Crohn’s-like lymphoid reaction and tumor-infiltrating lymphocytes in colorectal cancer

“…The type, location, and density of immune cells are important factors affecting host immunity [23] . At present, the prognostic value of TILs in the primary tumor center and invasive margin has been supported by mounting evidence in solid tumors [24] , [25] , [26] , [27] . However, it is difficult to evaluate TILs at the edge of some tumor margins with infiltrative growth patterns [28] , while stromal tumor-infiltrating lymphocytes (sTILs) are easier to be quantified.…”

Immune Biomarkers in Triple-Negative Breast Cancer: Improving the Predictivity of Current Testing Methods

“…In early BC, the presence of higher stromal TIL levels has been associated with a better response to the ICIs in numerous trials, indicating that fluctuation of TIL levels over time holds promise as a potential indicator for predicting the efficacy of ICI treatment [65,66]. In the context of metastatic spread, elevated TIL levels have been associated with an increased probability of positive response to ICI treatment, as well as improved OS and DFS in patients with TNBC [53,[67][68][69]. In locally advanced TNBC, a high TIL count has demonstrated noteworthy predictive and prognostic implications.…”