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Tumor Infiltrating Lymphocytes As A Prognostic Marker In Locally Advanced Breast Cancer With Hormone Receptor Negative Her-2 Positive Disease / Mostafa Magdy Mohamed Saber ; Supervised Heba M. Elzawahry , Amany M. Hilal

By: Contributor(s): Material type: TextTextLanguage: English Publication details: Cairo : Mostafa Magdy Mohamed Saber , 2021Description: 127 P . : charts , facsimiles ; 25cmOther title:
  • سلبية للمستقبلات الهرمونية و حاملة مستقبلات HER2القيم التنبؤية للخلايا الليمفاوية المتغلغلة في أورام الثدي السرطانية المتقدمة [Added title page title]
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Dissertation note: Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology (Medical) Summary: Introduction: The identification of prognostic and predictive biomarkers is an important goal in breast cancer. Special attention has been focused on the effect of the immune system on tumor response and prognosis as new therapies modulating the immune system have reached the clinical setting. The presence of infiltrating lymphocytes within or around the tumor has been reported as an important biomarker linked with clinical outcome. Aim: To study the association between the level of stromal tumor infiltrating lymphocytes (TILs) and DFS in a group of ER &PR negative, HER-2 positive locally advanced breast cancer patients who received curative intent surgery. Methods: This is a retrospective cohort study included 66 locally advanced hormone receptor-negative; HER2 + breast cancer patients presented between 2013 & 2015 at NCI-Cairo University. Patients were followed from date of breast surgery till date of relapse for a minimum of 36 months. TILs and CD8 antigen were assessed on paraffin-embedded blocks using immunohistochemistry methods.Results: The median age of the patients was 52 years. Majority of the patients presented with clinical T3 (53%), N1 (61%). Surgery was MRM in 79%. Only 41% received neoadjuvant chemotherapy and 56% received trastuzumab. TILs were 50, 17 and 33% for absent, intermediate and extensive groups respectively*. CD8+ lymphocytes were present in 80% of cases. At the end of follow up period (range 1-70 months), 23 patients (35%) were found to have disease recurrence either loco-regional or distant in 22 and 78%, respectively. The mean and median diseasefree survival (DFS) were, 33.8 and 36 months respectively. TILs were 14, 4 and 5% for absent, intermediate and extensive respectively. CD8+ lymphocytes were absent in 6% and present ({u2265}1%) in 17%. Higher DFS was recorded for patients with extensive TILs level only in patients who received trastuzumab (p=0.032). Also, TILs levels of >20% were also associated with longer DFS (p=0.049; 95%CI: 0.198-0.99). Several cut-offs for CD8+ lymphocytes were used to correlate with DFS. Using mean value of CD8 level of {u2265}12% was significantly correlated with DFS (p=0.035; 95%CI= 0.863-22.35)
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Item type Current library Home library Call number Copy number Status Date due Barcode
Thesis Thesis قاعة الرسائل الجامعية - الدور الاول المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.19.04.Ph.D.2021.Mo.T (Browse shelf(Opens below)) Not for loan 01010110085636000
CD - Rom CD - Rom مخـــزن الرســائل الجـــامعية - البدروم المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.19.04.Ph.D.2021.Mo.T (Browse shelf(Opens below)) 85636.CD Not for loan 01020110085636000

Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology (Medical)

Introduction: The identification of prognostic and predictive biomarkers is an important goal in breast cancer. Special attention has been focused on the effect of the immune system on tumor response and prognosis as new therapies modulating the immune system have reached the clinical setting. The presence of infiltrating lymphocytes within or around the tumor has been reported as an important biomarker linked with clinical outcome. Aim: To study the association between the level of stromal tumor infiltrating lymphocytes (TILs) and DFS in a group of ER &PR negative, HER-2 positive locally advanced breast cancer patients who received curative intent surgery. Methods: This is a retrospective cohort study included 66 locally advanced hormone receptor-negative; HER2 + breast cancer patients presented between 2013 & 2015 at NCI-Cairo University. Patients were followed from date of breast surgery till date of relapse for a minimum of 36 months. TILs and CD8 antigen were assessed on paraffin-embedded blocks using immunohistochemistry methods.Results: The median age of the patients was 52 years. Majority of the patients presented with clinical T3 (53%), N1 (61%). Surgery was MRM in 79%. Only 41% received neoadjuvant chemotherapy and 56% received trastuzumab. TILs were 50, 17 and 33% for absent, intermediate and extensive groups respectively*. CD8+ lymphocytes were present in 80% of cases. At the end of follow up period (range 1-70 months), 23 patients (35%) were found to have disease recurrence either loco-regional or distant in 22 and 78%, respectively. The mean and median diseasefree survival (DFS) were, 33.8 and 36 months respectively. TILs were 14, 4 and 5% for absent, intermediate and extensive respectively. CD8+ lymphocytes were absent in 6% and present ({u2265}1%) in 17%. Higher DFS was recorded for patients with extensive TILs level only in patients who received trastuzumab (p=0.032). Also, TILs levels of >20% were also associated with longer DFS (p=0.049; 95%CI: 0.198-0.99). Several cut-offs for CD8+ lymphocytes were used to correlate with DFS. Using mean value of CD8 level of {u2265}12% was significantly correlated with DFS (p=0.035; 95%CI= 0.863-22.35)

Issued also as CD

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