Purpose: The immune microenvironment of breast ductal carcinoma in situ (DCIS) has yet to be fully explored, and the relationship of immune cells to genetic features of DCIS is unknown.Experimental Design: We quantified tumor associated lymphocytes (TIL) and evaluated PD-L1 protein levels by immunohistochemistry in a cohort of pure DCIS (138 and 79 cases, respectively), some of which had copy number (n = 55) and mutation data (n = 20).Results: TILs were identified in the stroma surrounding DCIS (119/138, 86%) and present at a median TIL score of 5% (range, 0%-90%). Most DCIS were negative for tumor cell PD-L1 staining (89%), but 25% of cases were positive for immune cell staining. We observed that, as in invasive breast cancer, TILs and PD-L1 positivity were significantly greater in high-grade (P = 0.002/0.035), ER-negative (P = 0.02/0.02), and ERBB2-amplified tumors (P < 0.001/0.048). Comedo necrosis was significantly positively associated with TILs (P < 0.0001) but not with PD-L1. The TILs score was significantly higher in cases with TP53 mutation (P = 0.03) but not with PIK3CA or GATA3 mutation. In the cases with copy number data, both the fraction of the genome altered and the number of telomeric imbalances were significantly positively correlated with TILs (both P < 0.001). This result strongly contrasted with invasive breast cancer data, where aneuploidy was not correlated to TIL levels.Conclusions: Although a small cohort, our data suggest a preliminary model by which the progression of DCIS to invasive carcinoma may involve an altered relationship of tumor copy number with the immune microenvironment, possibly by the immunoediting of the tumor. Clin Cancer Res; 23(17); 5210-7. ©2017 AACR.

译文

目的:乳腺导管原位癌(DCIS)的免疫微环境尚未得到充分探索,并且免疫细胞与DCIS遗传特征的关系尚不清楚。实验设计:我们量化了肿瘤相关淋巴细胞(TIL)并评估了PD通过免疫组织化学检测一组纯DCIS(分别为138和79例)中的-L1蛋白水平,其中一些具有拷贝数(n = 55)和突变数据(n = 20)。 DCIS(119/138,86%),平均TIL得分为5%(范围:0%-90%)。大多数DCIS对肿瘤细胞PD-L1染色呈阴性(89%),但25%的病例对免疫细胞染色呈阳性。我们观察到,与浸润性乳腺癌一样,高级别(P = 0.002 / 0.035),ER阴性(P = 0.02 / 0.02)和ERBB2扩增的肿瘤中TIL和PD-L1阳性率显着更高(P < 0.001 / 0.048)。痤疮坏死与TILs呈显着正相关(P <0.0001),而与PD-L1无显着正相关。 TP53突变的患者的TILs评分显着更高(P = 0.03),而PIK3CA或GATA3突变的患者则没有。在具有拷贝数数据的情况下,基因组的比例改变和端粒失衡的数目均与TILs显着正相关(均P <0.001)。该结果与浸润性乳腺癌数据形成鲜明对比,后者的非整倍性与TIL水平无关。结论:尽管队列比较小,但我们的数据提示了初步模型,通过该模型DCIS向浸润性癌进展可能涉及肿瘤拷贝数关系的改变免疫微环境,可能是通过肿瘤的免疫编辑。临床癌症研究; 23(17); 5210-7。 ©2017 AACR。

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