Peritumoral immune infiltrates in primary tumours are not associated with the presence of axillary lymph node metastasis in breast cancer: a retrospective cohort study.

BACKGROUND: The axillary lymph nodes (ALNs) in breast cancer patients are the body regions to where tumoral cells most often first disseminate. The tumour immune response is important for breast cancer patient outcome, and some studies have evaluated its involvement in ALN metastasis development. Most studies have focused on the intratumoral immune response, but very few have evaluated the peritumoral immune response. The aim of the present article is to evaluate the immune infiltrates of the peritumoral area and their association with the presence of ALN metastases. METHODS: The concentration of 11 immune markers in the peritumoral areas was studied in 149 patients diagnosed with invasive breast carcinoma of no special type (half of whom had ALN metastasis at diagnosis) using tissue microarrays, immunohistochemistry and digital image analysis procedures. The differences in the concentration of the immune response of peritumoral areas between patients diagnosed with and without metastasis in their ALNs were evaluated. A multivariate logistic regression model was developed to identify the clinical-pathological variables and the peritumoral immune markers independently associated with having or not having ALN metastases at diagnosis. RESULTS: No statistically significant differences were found in the concentrations of the 11 immune markers between patients diagnosed with or without ALN metastases. Patients with metastases in their ALNs had a higher histological grade, more lymphovascular and perineural invasion and larger-diameter tumours. The multivariate analysis, after validation by bootstrap simulation, revealed that only tumour diameter (OR = 1.04; 95% CI [1.00-1.07]; p = 0.026), lymphovascular invasion (OR = 25.42; 95% CI [9.57-67.55]; p < 0.001) and histological grades 2 (OR = 3.84; 95% CI [1.11-13.28]; p = 0.033) and 3 (OR = 5.18; 95% CI [1.40-19.17]; p = 0.014) were associated with the presence of ALN metastases at diagnosis. This study is one of the first to study the association of the peritumoral immune response with ALN metastasis. We did not find any association of peritumoral immune infiltrates with the presence of ALN metastasis. Nevertheless, this does not rule out the possibility that other peritumoral immune populations are associated with ALN metastasis. This matter needs to be examined in greater depth, broadening the types of peritumoral immune cells studied, and including new peritumoral areas, such as the germinal centres of the peritumoral tertiary lymphoid structures found in extensively infiltrated neoplastic lesions.

Infección tuberculosa latente en trabajadores sanitarios de un hospital general básico en Cataluña / Latent tuberculosis infection in healthcare personnel at a primary level general hospital in Catalonia, Spain

El objetivo del trabajo ha sido evaluar la presencia de infección tuberculosa latente en el personal sanitario del Hospital de Tortosa Verge de la Cinta (HTVC). Para ello se analizaron las historias clínicas laborales de 398 trabajadores de dicho hospital a los que se había realizado la prueba de tuberculina durante el periodo 2001-2012. La presencia de infección tuberculosa latente (ITL) se analizó en relación a las variables edad, sexo, categoría profesional, personal de áreas de trabajo de alto y bajo riesgo de exposición a la tuberculosis y personal de riesgo no definido. La prevalencia total de ITL en el grupo estudiado fue del 11,1% (IC 95%: 8,3%-14,5%), estando dicha prevalencia asociada a la edad y al área de trabajo. El análisis multivariable mostró que el riesgo de sufrir ITL se incrementa un 6,4% por cada año de edad. La prevalencia de ITL en el centro de estudio era similar a la de la población profesionalmente no expuesta de España

The aim was to analyze the prevalence of latent tuberculosis infection and associated risk factors in healthcare personnel at the Hospital de Tortosa Verge de la Cinta (Tarragona, Spain). This was a cross-sectional study of 398 workers at this hospital who underwent tuberculin skin testing for latent tuberculosis infection (LTBI) between 2001 and 2012.We also analyzed the relationship between LTBI and age, sex, job and work area according to their risk of exposure to tuberculosis(high, low, uncertain). The total prevalence of LTBI in our sample was 11.1% (95%CI 8.3%-14.5%). LBTI was associated with age and work area. Multivariate analysis showed that the risk of LTBI increased by 6.4% per 1 year increase in age. The prevalence of LTBI in this population approximates that of the general population in Spain

[Latent tuberculosis infection in healthcare personnel at a primary level general hospital in Catalonia, Spain]. / Infección tuberculosa latente en trabajadores sanitarios de un hospital general básico en Cataluña.

The aim was to analyze the prevalence of latent tuberculosis infection and associated risk factors in healthcare personnel at the Hospital de Tortosa Verge de la Cinta (Tarragona, Spain). This was a cross-sectional study of 398 workers at this hospital who underwent tuberculin skin testing for latent tuberculosis infection (LTBI) between 2001 and 2012.We also analyzed the relationship between LTBI and age, sex, job and work area according to their risk of exposure to tuberculosis(high, low, uncertain). The total prevalence of LTBI in our sample was 11.1% (95%CI 8.3%-14.5%). LBTI was associated with age and work area. Multivariate analysis showed that the risk of LTBI increased by 6.4% per 1 year increase in age. The prevalence of LTBI in this population approximates that of the general population in Spain.

El objetivo del trabajo ha sido evaluar la presencia de infección tuberculosa latente en el personal sanitario del Hospital de Tortosa Verge de la Cinta (HTVC). Para ello se analizaron las historias clínicas laborales de 398 trabajadores de dicho hospital a los que se había realizado la prueba de tuberculina durante el periodo 2001-2012. La presencia de infección tuberculosa latente (ITL) se analizó en relación a las variables edad, sexo, categoría profesional, personal de áreas de trabajo de alto y bajo riesgo de exposición a la tuberculosis y personal de riesgo no definido. La prevalencia total de ITL en el grupo estudiado fue del 11,1% (IC 95%: 8,3%-14,5%), estando dicha prevalencia asociada a la edad y al área de trabajo. El análisis multivariable mostró que el riesgo de sufrir ITL se incrementa un 6,4% por cada año de edad. La prevalencia de ITL en el centro de estudio era similar a la de la población profesionalmente no expuesta de España.