Cel·lularitat immune als ganglis limfàtics axil·lars negatius en pacients amb càncer de mama

Identificador:  TDX:3371

Handle: https://hdl.handle.net/20.500.11797/TDX3371

Autores:  Bosch Príncep, Ramon

Resumen:
ntroduction: Tumor cells can modify the immune response in primary tumors and in the axillary lymph nodes with metastasis (ALN+) in breast cancer (BC), influencing patient outcome. We investigated whether patterns of immune cells in the primary tumor and in the axillary lymph nodes without metastasis (ALN-) differed between patients diagnosed without ALN+ ( pdALN-) and with ALN+ (pdALN+) and the implications for clinical outcome. Material and methods: Eleven immune markers were studied using immunohistochemistry, tissue microarray, and digital image analysis in 141 BC patient samples (75 pdALN+ and 66 pdALN-). Two logistic regression models were derived to identify the clinical, pathologic, and immunologic variables associated with the presence of ALN+ at diagnosis. Results: PdALN+ had significantly larger tumors, higher percentages of lymphovascular and perineural invasion and a higher histologic grade than pdALN-. We found several immune patterns in the ALN- associated with the presence of ALN+ at diagnosis. The regression models revealed a small subgroup of pdALN+ with ALN- immune patterns that were more similar to those of the ALN- of the pdALN-. This small subgroup also showed similar clinical behavior to that of the pdALN-. Another small subgroup of pdALN- with ALN- immune patterns was found whose members were more similar to those of the ALN- of the pdALN+. This small subgroup had similar clinical behavior to the pdALN+. Discussion: These data suggest that some immune populations present in ALN- at diagnosis are associated with having metastasis in the ALN at diagnosis but also highlight that they could influence the clinical outcome of BC patients.