Immunohistochemical analysis of tumor-infiltrating lymphocytes in breast carcinoma: relation to prognostic variables.

BACKGROUND: The role of the tumor-infiltrating lymphocytes in invasive breast cancer and its correlation with different prognostic variables were always a matter of controversy in the literature. AIM: To determine the relative density of T lymphocytes, CD4+ cells, CD8+ cells, and B lymphocytes in breast cancer and assess their relationships with clinicopathologic parameters. MATERIALS AND METHODS: Paraffin-embedded tissue sections from 48 invasive ductal carcinomas and 30 benign breast lesions were examined by means of immunohistochemistry to demonstrate CD3+, CD4+, CD8+, and CD20+. The immunophenotyped cells were semi-quantitatively graded into: Absent, intermediate, and extensive. RESULTS: All lymphocyte populations were significantly more expressed in breast carcinomas than in benign lesions (P = 0.0001 for CD3+ and CD4+, P = 0.001 for CD8+, and P = 0.002 for CD20+ cells). In breast carcinoma, B and T cells were co-expressed in 33 of 48 tumors (68.8%). However, T cells were the predominant immunophenotype being noted in 81% of tumors, compared to B cells which were expressed in 50% of tumors. T cells, CD4+ and CD8+ cells were directly associated with patient's age (P = 0.004, P = 0.001, and P = 0.01, respectively). Clinical stages III and IV showed a significantly higher density of T and CD4+ lymphocytes than stage II (P = 0.004 and P = 0.009, respectively). Also, T and CD4+ cells were directly related to the histologic grade (P = 0.004 and P = 0.001, respectively). On the contrary, B lymphocytes were not related to any of the above-mentioned parameters. CONCLUSION: Although B and T lymphocytes were co-expressed in breast cancer, T lymphocytes and their subpopulations seem to have the upper hand in predicting the biological behavior. They probably promote neoplastic progression rather than acting as an antitumor immune response.

Immunohistochemical expression of mismatch repair genes (hMSH2 and hMLH1) in hepatocellular carcinoma in Egypt.

Egypt has the highest prevalence rate of hepatitis C virus (HCV) infection in the world. HCV contributes to the development of about 70% of hepatocellular carcinoma (HCC) cases. Understanding the molecular basis of hepatocarcinogenesis is important for planning the therapeutic regimen for HCC patients. To clarify the possible role of mismatch repair (MMR) genes in HCV-related HCC, we studied 50 HCV-related HCC specimens (28 of which were with adjacent non-cancerous cirrhotic liver tissue, ANCLT) and 30 specimens of chronic liver disease (CLD) with no evidence of HCC. All cases were examined immunohistochemically to demonstrate the protein expression of hMSH2 and hMLH1. Thirty-two (64%) and 35 (70%) of the HCC cases revealed reduced expression of hMSH2 and hMLH1, respectively. Reduced expression of both the proteins was obtained in 26 (52%) of the HCC cases. The expression of hMSH2 and hMLH1 was reduced in 53.6% and 64.3% of ANCLT cases, respectively, with no significant difference between HCC and ANCLT. All 30 specimens of CLD had preserved expression of hMSH2 and hMLH1. Multivariate analysis showed that the reduced expression of hMSH2 or hMLH1 was significantly associated with higher grades of the tumor (p = 0.002 and 0.02, respectively).The relationships of these MMR genes with other clinicopathologic factors were not significant. Reduced expression of hMSH2 and hMLH1 in both HCC and ANCLT suggests that this event occurs at early stages of HCV-related hepatocarcinogenesis. Moreover, the significant association between reduced expression of both MMR genes and poor histologic grades of the tumor claims that these proteins are involved in the process of cancer progression.