Expression Level Of Tumor-infiltrating Lymphocytes Relationship With Prognosis And Clinical Outcomes In Triple Negative Breast Cancer Tumor

Objects: Tumor infiltrating lymphocytes have been consistently documented in breast cancer,especially in triple negative breast cancer.This study aimed to rsearch the relationship between the expression level of tumor infiltrating lymphocytes and clinical manifestations of triple negative breast cancer patients,especially the prognostic value of tumor infiltrating lymphocytes.Methods: Retrospectively collected clinical data of 453 female cases of triple negative breast cancer patients,pathological data and paraffin-embedded pathological specimens,using hematoxylin and eosin detection of stroma lymphocytic infiltrates,intra-tumoral lymphocytic infiltrates,total tumor infiltrating lymphocytes in primary tumors of triple negative breast cancer.We used SPSS statistics software version 19 to perform all statistical analyses.Kaplan-Meier survival curves were generated to examine the relationship between the expression levels of Tumor infiltrating lymphocytes and patients' survival rate.Univariate and multivariate COX factor analysis were used to analyze disease-free survival and overall survival related factors.The statistical significance among two groups was determined using chi-square test,or two-sample t-test as appropriate.The statistical significance which is described by figures and charts was set at a p-value of 0.05.Results: Stroma lymphocytic infiltrates expression were related to lymph node and clinical stage(P<0.05).Stroma lymphocytic infiltrates expression were independent of tumor size,histological grade,Ki67 expression and other indicators in our experiment(P>0.05).The growth of stroma lymphocytic infiltrates was significantly associated with better prognosis.Univariate Cox proportional hazards model analysis showed that lymph node,clinical stage,stroma lymphocytic infiltrates,intra-tumoral lymphocytic infiltrates,total tumor infiltrating lymphocytes were associated with DFS and OS(both P<0.05).In our experiment,we found that lymph node and clinical stage were hazardous factor for DFS(HR=2.108?3.051,P<0.05)and OS(HR=2.079?3.046,P<0.05).Instead,stroma lymphocytic infiltrates,intra-tumoral lymphocytic infiltrates,total tumor infiltrating lymphocytes were protective factor for DFS(HR=0.036?0.029?0.035,P<0.05)and OS(HR=0.047?0.040?0.048,P<0.05).Multivariate Cox proportional hazards model analysis showed that stroma lymphocytic infiltrates,intra-tumoral lymphocytic infiltrates were protective factor for DFS(HR=0.065?0.033,P<0.05)and OS(HR=0.056?0.039,P<0.05),both were an independent prognostic factor of TNBC prognosis.Conclusion: Our study found that the presence of increased stroma lymphocytic infiltrates was significantly associated with better prognosis.It has yet to be proved in intra-tumoral lymphocytic infiltrates and total tumor infiltrating lymphocytes.In conclusion,our findings showed that stroma lymphocytic infiltrates and intra-tumoral lymphocytic were an independent prognostic factor for triple negative breast cancer prognosis.