CLINICOPATHOLOGICAL CHARACTERISTICS & IMMUNOHISTOCHEMICAL EXPRESSION OF CD4+ AND CD8+ TUMOR INFILTRATING LYMPHOCYTES AS PROGNOSTIC INDICATORS IN INVASIVE DUCTAL CARCINOMA IN NORTHERN PAKISTAN
Objectives: To analyze the expression of CD 4+ and CD8+ Tumor infiltrating lymphocytes and their correlation with different clinicopathological characteristics in invasive ductal carcinoma breast in Northern Pakistan.
Study design: Descriptive, cross sectional study.
Place & duration of study: Armed forces institute of pathology, Rawalpindi from January 2015 to December 2015.
Materials & Methods: A total of 100 newly diagnosed and untreated cases of invasive ductal carcinoma were selected who underwent modified radical mastectomy procedure at CMH, Rawalpindi. Paraffin embedded tissue sections were assessed by immunohistochemical assays for CD4+, CD8+ T lymphocytes and hormone receptor status.
Results: Out of 100 cases of invasive ductal carcinoma, the average age of patient was 47.3 ± 11.77 years. Only 23% of cases were free of axillary lymph node involvement whereas 77% of cases showed lymph node involvement. In CD4+ TILs subset, 26% of cases showed minimal expression (0-19%), 62% of cases showed moderate expression (20-49%) and 12% of cases showed marked expression (50-90%). In CD8+ TILs subset, 38% of cases showed minimal expression (0-19%) and 62% of cases showed moderate expression (20-49%). No CD8+TILs were seen in marked expression group. Patients who showed moderate to marked expression of TILs were associated with negative axillary lymph node involvement.
Conclusion: CD4+ and CD8+ TILs not only predict the biological behavior and prognosis in invasive ductal carcinoma breast but they also are associated with decreased axillary lymph node metastasis.Key words: Tumor infiltrating lymphocytes (TILs), Invasive ductal carcinoma, Bloom Richardson grade.