Study of CD4 biomarker in Breast Carcinoma and Its Correlation with Clinical Parameters

Abstract

Background

Breast carcinoma is one of the biggest causes of cancer worldwide. Breast carcinoma is one of the highest cases of morbidity and death in women in India.  Despite the existence of this immune response, many breast cancers progress and spread, questioning the function of tumor infiltrating lymphocytes in the tumor micro environment. There is a controversy around the precise role of TILs in breast carcinoma i.e whether they are present as nonspecific inflammatory reaction or a specific immunologic response. The purpose of this study was to assess the role of CD4+ TILs in breast cancer tissues. Breast cancer tumor type, histological grading, clinical stage, lymph node status, and hormone receptor status are among the traditional prognostic factors.  Correlation between these factors and tumor infiltrating lymphocytes is studied to know their future role in breast carcinoma.

METHODS

45 cases of breast carcinoma patients were studied and various clinicopathological parameters were noted. IHC staining for ER, PR, Her2neu and CD4 marker in tissue sections was done and CD4 intratumoral and stromal TILs were counted and correlated with clinicopathological prognostic factors.

RESULTS

Intratumoral and stromal CD4 expression was detected in all 45 cases of breast carcinoma studied. CD4 stromal expression and intra-tumoral expression did not show any correlation with age, histological grade, tumor size, lymph node status, ER, PR, or HER2Neu status. In the triple-negative breast cancers, high stromal CD4 expression was noted.

CONCLUSION

The recruitment and deposition of large numbers of lymphocytes in tumor tissue acts as an important local barrier to neoplastic progression. The presence of substantial TILs in the tumor promotes improved clinical outcomes. Tumor infiltrating lymphocytes should be routinely evaluated as a prognostic marker for aggressive breast cancers, including triple negative breast cancers. We identified a higher concentration of stromal CD4 TILs in triple negative breast tumors.