ABSTRACT
Triple negative breast cancer (TNBC) is highly immunogenic and high levels of tumor infiltrating lymphocytes (TILs) have been associated with a better prognosis and higher probability to achieve pathological complete response. Here, we explore the potential role of stromal TILs level and composition as a prognostic and predictive biomarker in TNBC. 195 Tumor biospecimens from patients diagnosed with TNBC were included. Stromal TILs (sTILs), positive CD4/CD8 cells were evaluated. Differences in clinic-pathological characteristics according to immune infiltration were assessed. The predictive and prognostic value of immune infiltration was analyzed by multivariate models. Higher immune infiltration was observed in patients with favorable clinical-pathological features. Survival analysis showed that longer overall survival times were observed in patients with a higher infiltration of sTILs (p = 0.00043), CD4 + (p = 0.0074) and CD8 + (p = 0.008). In the multivariate analysis, low levels of sTILs were found to be associated with a higher mortality hazard (HR: 1.59, 95% CI 1.01-2.48). CD4 and CD8 immune infiltration were associated with higher odds for pathological complete response (OR: 1.20, 95% CI 1.00-1.46, OR: 1.28, 1.02-1.65, respectively). Our results suggest that immune infiltration could be used as a prognostic marker for overall survival in TNBC patients.
Subject(s)
Triple Negative Breast Neoplasms , Humans , Triple Negative Breast Neoplasms/pathology , Lymphocytes, Tumor-Infiltrating , Colombia , Prognosis , Biomarkers , Biomarkers, Tumor/analysisABSTRACT
Histologic transformation of low-grade B-cell lymphoma to diffuse large B-cell lymphoma is associated with poor prognosis. Although plasma cell differentiation is common in these lymphomas, an overt plasmablastic transformation (PBL-T) has been only rarely reported. We report 6 cases of PBL-T occurring in 3 chronic lymphocytic leukemias (CLL) and 3 follicular lymphomas. Five patients were men, and the mean age was 65 years (range, 52 to 72 y). None of them had history of immunodeficiency. In 3 cases the PBL-T occurred 34 to 85 months after the initial diagnosis, and in 3 it was detected simultaneously with the small cell component at diagnosis. All patients received chemotherapy after transformation, and 4 died 4 to 24 months after this diagnosis. In 3 cases, PBL-T occurred in an extranodal site. All PBL-Ts had immunoblastic morphology with admixed plasma cells, were CD20 and PAX5 negative, expressed λ light chain, and 5 were CD138 positive. All cases were negative for HHV8, and only 1 PBL-T was Epstein-Barr virus positive. Evidence of a clonal relationship between the small cell and PBL-T components was found in 5 cases. In 2 CLL cases, both components had 13q deletions, and in all follicular lymphoma cases both components harbored the t(14;18) translocation. MYC translocations were observed in 2 cases transformed from a CLL. In conclusion, PBL-T expands the clinicopathologic spectrum of the transformation of low-grade B-cell lymphomas. These transformed tumors are clinically, histologically, and phenotypically similar to primary plasmablastic lymphomas, but they are not associated with immunodeficiency and rarely have Epstein-Barr virus infection or MYC alterations.
Subject(s)
Cell Transformation, Neoplastic/pathology , Lymphoma, B-Cell/pathology , Plasmacytoma/pathology , Aged , Chromosome Aberrations , Clone Cells , DNA, Neoplasm/analysis , Fatal Outcome , Female , Humans , In Situ Hybridization, Fluorescence , Lymphoma, B-Cell/genetics , Lymphoma, B-Cell/mortality , Male , Middle AgedABSTRACT
Las metástasis de los tumores sólido se producen cuando las células de un carcinoma primario o metastásico migran en el sistema circulatorio y proliferan en lugares distantes del organismo. Los carcinomas son de origen epithelial, y no es habitual que estas células se encuentren en el torrente circulatorio. La presencia de células tumorales circulantes (CTC) en sangre periférica detectadas con CellSearch(R) Circulating Tumor Cell System, está asociada a menor supervivencia libre de enfermedad (SLE) y menor supervivencia global (SG) en pacientes de cáncer de mama, colorrectal y de próstata metastatizante. Esta prueba sirve para ayudar en la monitorización de pacientes con cáncer de mama, colorrectal o próstata. Además, en el presente artículo revisamos otras técnicas de detección de células tumorales circulantes y su aplicabilidad (AU)
Cancer metastasis occurs when cells shed from a primary or metastatic tumor, enter the circulation, and begin to grow in distant locations of the body. Carcinomas are derived from epithelial cells that are not normally found in circulation. The presence of circulating tumor cells (CTC) in the peripheral blood, as detected by the CellSearch(R) Circulating Tumor Cell Kit, is associated with disease free survival and decreased overall survival in patients treated for metastatic breast, colorectal or prostate cancer. The test is to be used as an aid in the monitoring of patients with metastatic breast, colorectal or prostate cancer. In our article we will evaluate other methods of analysing circulating tumor cells and their clinical application (AU)
