الفهرس | Only 14 pages are availabe for public view |
Abstract Introduction Neoadjuvant chemotherapy that is designed to be used prior to surgical removal of a tumor has received significant attention. There is evidence that if neoadjuvant chemotherapy leads to complete pathologic response, the patient will enjoy better outcome. There is pathological and clinical variables which affect patient outcome after NAC , one of them and most recent is tumor-infiltrating lymphocytes (TILs) in breast cancer which is now believed that they have predictive and prognostic roles in breast cancer. We investigated TIL levels before, after chemotherapy, and their dynamics during treatment; and we assessed the correlation of these levels with response to NAC and prognosis. Patient and methods: We identified 70 patients with primary breast cancers receiving NAC; we analyzed pre- and post-treatment hormonal status, ki67 and tumor-infiltrating immune cells (CD3, CD8) by immunohistochemistry. Immune cell profiles were analyzed and correlated with response and survival. Results: We identified two tumor-infiltrating immune cell profiles, which were able to predict pathological complete response (pCR) to neoadjuvant chemotherapy. A higher infiltration by CD8 and CD3 lymphocytes was associated with occurrence of pCR. Analysis of the immune infiltrate in post-chemotherapy treatment identified a profile of high CD8 and low CD3 infiltration associated with better disease free survival. Patients with low levels of ki67 had better outcome and prolonged DFS from those with high levels of ki67 post NAC. |