ABSTRACT
BACKGROUND: The axillary lymph nodes (ALNs) in breast cancer patients are the body regions to where tumoral cells most often first disseminate. The tumour immune response is important for breast cancer patient outcome, and some studies have evaluated its involvement in ALN metastasis development. Most studies have focused on the intratumoral immune response, but very few have evaluated the peritumoral immune response. The aim of the present article is to evaluate the immune infiltrates of the peritumoral area and their association with the presence of ALN metastases. METHODS: The concentration of 11 immune markers in the peritumoral areas was studied in 149 patients diagnosed with invasive breast carcinoma of no special type (half of whom had ALN metastasis at diagnosis) using tissue microarrays, immunohistochemistry and digital image analysis procedures. The differences in the concentration of the immune response of peritumoral areas between patients diagnosed with and without metastasis in their ALNs were evaluated. A multivariate logistic regression model was developed to identify the clinical-pathological variables and the peritumoral immune markers independently associated with having or not having ALN metastases at diagnosis. RESULTS: No statistically significant differences were found in the concentrations of the 11 immune markers between patients diagnosed with or without ALN metastases. Patients with metastases in their ALNs had a higher histological grade, more lymphovascular and perineural invasion and larger-diameter tumours. The multivariate analysis, after validation by bootstrap simulation, revealed that only tumour diameter (OR = 1.04; 95% CI [1.00-1.07]; p = 0.026), lymphovascular invasion (OR = 25.42; 95% CI [9.57-67.55]; p < 0.001) and histological grades 2 (OR = 3.84; 95% CI [1.11-13.28]; p = 0.033) and 3 (OR = 5.18; 95% CI [1.40-19.17]; p = 0.014) were associated with the presence of ALN metastases at diagnosis. This study is one of the first to study the association of the peritumoral immune response with ALN metastasis. We did not find any association of peritumoral immune infiltrates with the presence of ALN metastasis. Nevertheless, this does not rule out the possibility that other peritumoral immune populations are associated with ALN metastasis. This matter needs to be examined in greater depth, broadening the types of peritumoral immune cells studied, and including new peritumoral areas, such as the germinal centres of the peritumoral tertiary lymphoid structures found in extensively infiltrated neoplastic lesions.
ABSTRACT
Objetivo. Comparar la supervivencia del cáncer de mama en mujeres que han sido cribadas en el programa de Detección Precoz del Cáncer de Mama (DPCM) y en las que no han participado en él. Pacientes y métodos. Es un estudio descriptivo y longitudinal en el que se han estudiado todos los cánceres de mama registrados en el servicio de Anatomía Patológica del Hospital de Tortosa Verge de la Cinta (Tarragona) de mujeres de 50-65 años, que se habían detectado la enfermedad ellas mismas o que la había detectado el programa DPCM, desde junio de 1999 hasta junio de 2003. Se registraron 101 pacientes con cáncer de mama, de las que en 84 se pudieron recoger todos los datos relativos al tumor, la cirugía y el tratamiento. En el 2014, tras un seguimiento de 11,6 ± 1,8 años, se anotó el estado actual. Resultados. No hay diferencia estadísticamente significativa en la supervivencia de los 2 grupos. Pacientes con carcinoma in situ y sin ganglios metastásicos se encuentran entre las fallecidas, mientras que ninguna paciente con carcinoma bien diferenciado falleció. Conclusiones. En nuestro estudio, el cribado del cáncer de mama no mejora la supervivencia y determinados factores en los que se apoyan los programas de cribado, como la detección de carcinomas no infiltrantes y/o de ganglios no metastásicos, no aseguran la curación (AU)
Objective. To compare survival in breast cancer between women diagnosed in an early breast cancer detection programme and those not attending this programme. Patients and methods. We conducted a descriptive and longitudinal study that analysed all types of breast cancer registered in the Pathology Service of the Hospital de Tortosa Verge de la Cinta (Tarragona, Spain). Tumour samples were obtained from 50-65-year-old women who had detected alterations on self-examination and from those attending the early breast cancer detection programme from June 1999 to June 2003. All the information relating to the tumour, surgery or treatment was registered. In 2014, after a follow-up of 11.6 ± 1.8 years, the current status of each patient was recorded. Results. There was no significant statistical difference in survival between the two groups of patients. Non-survivors included patients with in situ carcinoma and without lymph node metastases. Survival was 100% in patients with well differentiated carcinoma. Conclusions. Breast cancer screening did not improve survival in our study. The elements on which screening programs are based, such as non-invasive carcinoma detection and/or non- metastatic lymph nodes, do not ensure recovery (AU)
Subject(s)
Humans , Female , Adult , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Mass Screening/classification , Mass Screening/methods , Lymph Nodes/metabolism , Spain/ethnology , Sentinel Lymph Node Biopsy/methods , Breast Neoplasms/drug therapy , Breast Neoplasms/therapy , Disease-Free Survival , Mass Screening/standards , Mass Screening , Lymph Nodes/abnormalities , Sentinel Lymph Node Biopsy/standardsABSTRACT
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Subject(s)
Middle Aged , Adult , Adolescent , Aged , Aged, 80 and over , Male , Infant , Female , Humans , Autoimmune Diseases , Species Specificity , Syndrome , Prospective Studies , Candida , Conversion Disorder , Institutionalization , Lymphoproliferative DisordersABSTRACT
Fundamento: Se pretende determinar la proporción de enfermedad de Hodgkin (EH) que expresa el virus de Epstein-Barr (VEB) en nuestro medio. Pacientes y métodos: Se ha realizado un estudio retrospectivo sobre 49 casos de EH usando la técnica inmunohistoquímica LMP-1 y la técnica de hibridación in situ para EBER-1. Resultados: Un 40,8 por ciento (20/49) de los casos expresaba VEB (EBER-1 y/o LMP-1 positivos). Este porcentaje fue significativamente mayor en EH diagnosticadas a pacientes mayores de 55 años y no hubo diferencias por sexo, aunque fue mayor, pero no de forma significativa, en el subtipo histológico de EH de celularidad mixta. Conclusiones: El VEB se asocia a un 40,8 por ciento de las EH en las comarcas de Tarragona (AU)