Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological features

BackgroundIn triple-negative breast cancer (TNBC), the most immunogenic breast cancer type, tumor-infiltrating lymphocytes (TILs) are an independent prognostic factor. Tertiary lymphoid structures (TLS) are an important TILs source, but they are not integrated in the current prognostic criteria.Meth...

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Main Authors: Florence Boissière-Michot, Marie-Christine Chateau, Simon Thézenas, Virginie Lafont, Evelyne Crapez, Priyanka Sharma, Angélique Bobrie, Pascal Roger, Séverine Guiu, William Jacot
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2024.1507371/full
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author Florence Boissière-Michot
Marie-Christine Chateau
Simon Thézenas
Virginie Lafont
Evelyne Crapez
Evelyne Crapez
Priyanka Sharma
Angélique Bobrie
Angélique Bobrie
Pascal Roger
Séverine Guiu
Séverine Guiu
William Jacot
William Jacot
William Jacot
William Jacot
author_facet Florence Boissière-Michot
Marie-Christine Chateau
Simon Thézenas
Virginie Lafont
Evelyne Crapez
Evelyne Crapez
Priyanka Sharma
Angélique Bobrie
Angélique Bobrie
Pascal Roger
Séverine Guiu
Séverine Guiu
William Jacot
William Jacot
William Jacot
William Jacot
author_sort Florence Boissière-Michot
collection DOAJ
description BackgroundIn triple-negative breast cancer (TNBC), the most immunogenic breast cancer type, tumor-infiltrating lymphocytes (TILs) are an independent prognostic factor. Tertiary lymphoid structures (TLS) are an important TILs source, but they are not integrated in the current prognostic criteria.MethodsIn this retrospective study, TLS were assessed in hematein-eosin-saffron-stained (HES) histological sections from 397 early, chemotherapy-naive TNBC samples after primary surgical resection. Their association with i) classical clinicopathological features, ii) TILs and CD3+, CD8+, CD20+ lymphoid populations, iii) CD68+, CD163+, CD11b+, CD66b+ myeloid populations, and iv) expression of the PD1/PD-L1 and PVR/TIGIT axis immune checkpoint components and their prognostic significance were evaluated.ResultsTLS were observed in 88.2% of samples, mainly in peritumoral areas (86.1%). Increased amount of peritumoral TLS (PT-TLS) was significantly associated with younger age (p<0.001), smaller tumor size and higher tumor grade (both, p<0.001), HER2null tumors (versus HER2low tumors, p<0.002), and non-lobular histological type (p<0.016). TNBC with higher PT-TLS abundance displayed more often a basal-like (p<0.001) and not molecular-apocrine phenotype (p<0.001). TLS abundance was associated with TILs and hot tumor inflammatory pattern (both, p<0.001). Remarkably, PT-TLS abundance was positively associated with the density of the analyzed lymphoid (CD3+, CD8+, CD20+) and myeloid (CD68+, CD163+, CD11b+) cell populations (all p<0.001), with the exception of CD66b+ cells, as well as with expression of the PD1/PD-L1 and TIGIT/PVR immune checkpoint markers. In univariate analysis, beside the classical clinicopathological factors (tumor size, node involvement and adjuvant chemotherapy), TILs, hot tumors and PT-TLS were significantly associated with clinical outcome. Moreover, the risk of relapse was inversely correlated with PT-TLS abundance (Kaplan-Meier analysis). In multivariate analysis, pathological stage, adjuvant chemotherapy and PT-TLS remained correlated with relapse-free survival.ConclusionOur results suggest that TLS are a frequent feature in early TNBC and that their presence, particularly at the tumor periphery, recapitulates the tumor immune microenvironment. In our series, their prognostic value outperformed that of TILs. Therefore, their easy quantification on routine HES sections and their integration into the factors classically analyzed by pathologists could improve the clinical management of TNBC, a breast cancer type whose prognosis remains too poor.
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spelling doaj-art-51acdca94bd14828bff63a57737f642e2025-08-20T02:33:48ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-12-011510.3389/fimmu.2024.15073711507371Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological featuresFlorence Boissière-Michot0Marie-Christine Chateau1Simon Thézenas2Virginie Lafont3Evelyne Crapez4Evelyne Crapez5Priyanka Sharma6Angélique Bobrie7Angélique Bobrie8Pascal Roger9Séverine Guiu10Séverine Guiu11William Jacot12William Jacot13William Jacot14William Jacot15Translational Research Unit, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FranceTranslational Research Unit, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FranceBiometry Department, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FranceInstitut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, FranceTranslational Research Unit, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FranceInstitut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, FranceInstitut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, FranceInstitut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, FranceDepartment of Medical Oncology, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FrancePathology Department, Nîmes University Hospital, Nîmes, FranceInstitut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, FranceDepartment of Medical Oncology, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FranceTranslational Research Unit, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FranceInstitut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Montpellier, FranceDepartment of Medical Oncology, Montpellier Cancer Institute Val d’Aurelle, Montpellier, FranceFaculty of Medicine, Montpellier University, Montpellier, FranceBackgroundIn triple-negative breast cancer (TNBC), the most immunogenic breast cancer type, tumor-infiltrating lymphocytes (TILs) are an independent prognostic factor. Tertiary lymphoid structures (TLS) are an important TILs source, but they are not integrated in the current prognostic criteria.MethodsIn this retrospective study, TLS were assessed in hematein-eosin-saffron-stained (HES) histological sections from 397 early, chemotherapy-naive TNBC samples after primary surgical resection. Their association with i) classical clinicopathological features, ii) TILs and CD3+, CD8+, CD20+ lymphoid populations, iii) CD68+, CD163+, CD11b+, CD66b+ myeloid populations, and iv) expression of the PD1/PD-L1 and PVR/TIGIT axis immune checkpoint components and their prognostic significance were evaluated.ResultsTLS were observed in 88.2% of samples, mainly in peritumoral areas (86.1%). Increased amount of peritumoral TLS (PT-TLS) was significantly associated with younger age (p<0.001), smaller tumor size and higher tumor grade (both, p<0.001), HER2null tumors (versus HER2low tumors, p<0.002), and non-lobular histological type (p<0.016). TNBC with higher PT-TLS abundance displayed more often a basal-like (p<0.001) and not molecular-apocrine phenotype (p<0.001). TLS abundance was associated with TILs and hot tumor inflammatory pattern (both, p<0.001). Remarkably, PT-TLS abundance was positively associated with the density of the analyzed lymphoid (CD3+, CD8+, CD20+) and myeloid (CD68+, CD163+, CD11b+) cell populations (all p<0.001), with the exception of CD66b+ cells, as well as with expression of the PD1/PD-L1 and TIGIT/PVR immune checkpoint markers. In univariate analysis, beside the classical clinicopathological factors (tumor size, node involvement and adjuvant chemotherapy), TILs, hot tumors and PT-TLS were significantly associated with clinical outcome. Moreover, the risk of relapse was inversely correlated with PT-TLS abundance (Kaplan-Meier analysis). In multivariate analysis, pathological stage, adjuvant chemotherapy and PT-TLS remained correlated with relapse-free survival.ConclusionOur results suggest that TLS are a frequent feature in early TNBC and that their presence, particularly at the tumor periphery, recapitulates the tumor immune microenvironment. In our series, their prognostic value outperformed that of TILs. Therefore, their easy quantification on routine HES sections and their integration into the factors classically analyzed by pathologists could improve the clinical management of TNBC, a breast cancer type whose prognosis remains too poor.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1507371/fulltertiary lymphoid structurestriple-negative breast cancertumor immune microenvironmentprognostic biomarkerpredictive biomarker
spellingShingle Florence Boissière-Michot
Marie-Christine Chateau
Simon Thézenas
Virginie Lafont
Evelyne Crapez
Evelyne Crapez
Priyanka Sharma
Angélique Bobrie
Angélique Bobrie
Pascal Roger
Séverine Guiu
Séverine Guiu
William Jacot
William Jacot
William Jacot
William Jacot
Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological features
Frontiers in Immunology
tertiary lymphoid structures
triple-negative breast cancer
tumor immune microenvironment
prognostic biomarker
predictive biomarker
title Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological features
title_full Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological features
title_fullStr Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological features
title_full_unstemmed Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological features
title_short Prognostic value of tertiary lymphoid structures in triple-negative breast cancer: integrated analysis with the tumor microenvironment and clinicopathological features
title_sort prognostic value of tertiary lymphoid structures in triple negative breast cancer integrated analysis with the tumor microenvironment and clinicopathological features
topic tertiary lymphoid structures
triple-negative breast cancer
tumor immune microenvironment
prognostic biomarker
predictive biomarker
url https://www.frontiersin.org/articles/10.3389/fimmu.2024.1507371/full
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