PMID- 29273955
OWN - NLM
STAT- MEDLINE
DCOM- 20190227
LR  - 20240316
IS  - 1573-7217 (Electronic)
IS  - 0167-6806 (Print)
IS  - 0167-6806 (Linking)
VI  - 168
IP  - 3
DP  - 2018 Apr
TI  - Prognostic value of tumor-stroma ratio combined with the immune status of tumors 
      in invasive breast carcinoma.
PG  - 601-612
LID - 10.1007/s10549-017-4617-6 [doi]
AB  - PURPOSE: Complex interactions occur between cancer cells and cells in the tumor 
      microenvironment. In this study, the prognostic value of the interplay between 
      tumor-stroma ratio (TSR) and the immune status of tumors in breast cancer 
      patients was evaluated. METHODS: A cohort of 574 breast cancer patients was 
      analyzed. The percentage of tumor stroma was visually estimated on Hematoxylin 
      and Eosin (H&E) stained histological tumor tissue sections. Immunohistochemical 
      staining was performed for classical human leukocyte antigen (HLA) class I, 
      HLA-E, HLA-G, markers for regulatory T (Treg) cells, natural killer (NK) cells 
      and cytotoxic T-lymphocytes (CTLs). RESULTS: TSR (P < .001) and immune status of 
      tumors (P < .001) were both statistically significant for recurrence free period 
      (RFP) and both independent prognosticators (P < .001) in which tumors with a high 
      stromal content behave more aggressively as well as tumors with a low immune 
      status. Ten years RFP for patients with a stroma-low tumor and high immune status 
      profile was 87% compared to 17% of patients with a stroma-high tumor combined 
      with low immune status profile (P < .001). Classical HLA class I is the most 
      prominent immune marker in the immune status profiles. CONCLUSIONS: Determination 
      of TSR is a simple, fast and cheap method. The effect on RFP of TSR when combined 
      with immune status of tumors or expression of classical HLA class I is even 
      stronger. Both are promising for further prediction and achievement of tailored 
      treatment for breast cancer patients.
FAU - Vangangelt, K M H
AU  - Vangangelt KMH
AUID- ORCID: 0000-0002-9553-4691
AD  - Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, 
      Leiden, The Netherlands.
FAU - van Pelt, G W
AU  - van Pelt GW
AD  - Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, 
      Leiden, The Netherlands.
FAU - Engels, C C
AU  - Engels CC
AD  - Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, 
      Leiden, The Netherlands.
FAU - Putter, H
AU  - Putter H
AD  - Department of Medical Statistics, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Liefers, G J
AU  - Liefers GJ
AD  - Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, 
      Leiden, The Netherlands.
FAU - Smit, V T H B M
AU  - Smit VTHBM
AD  - Department of Pathology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Tollenaar, R A E M
AU  - Tollenaar RAEM
AD  - Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, 
      Leiden, The Netherlands.
FAU - Kuppen, P J K
AU  - Kuppen PJK
AD  - Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, 
      Leiden, The Netherlands.
FAU - Mesker, W E
AU  - Mesker WE
AD  - Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, 
      Leiden, The Netherlands. w.e.mesker@lumc.nl.
LA  - eng
PT  - Journal Article
DEP - 20171222
PL  - Netherlands
TA  - Breast Cancer Res Treat
JT  - Breast cancer research and treatment
JID - 8111104
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (HLA-G Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers, Tumor/blood/*immunology
MH  - Breast Neoplasms/blood/*immunology/pathology
MH  - Disease-Free Survival
MH  - Female
MH  - Genes, MHC Class I/genetics
MH  - HLA-G Antigens/blood
MH  - Histocompatibility Antigens Class I/blood
MH  - Humans
MH  - Killer Cells, Natural/immunology
MH  - Lymphatic Metastasis
MH  - Middle Aged
MH  - Neoplasm Invasiveness/*immunology/pathology
MH  - Neoplasm Recurrence, Local/blood/immunology/pathology
MH  - *Prognosis
MH  - Stromal Cells/immunology/pathology
MH  - T-Lymphocytes, Regulatory/immunology
MH  - HLA-E Antigens
PMC - PMC5842256
OTO - NOTNLM
OT  - Breast cancer
OT  - HLA
OT  - Immune cells
OT  - Prognosis
OT  - Tumor-stroma ratio
COIS- CONFLICT OF INTEREST: The authors declare no potential conflicts of interest. 
      This study has not been presented elsewhere. No Disclaimers. ETHICAL STANDARDS: 
      The experiments which were performed comply with the current laws of the country.
EDAT- 2017/12/24 06:00
MHDA- 2019/02/28 06:00
PMCR- 2017/12/22
CRDT- 2017/12/24 06:00
PHST- 2017/08/10 00:00 [received]
PHST- 2017/12/07 00:00 [accepted]
PHST- 2017/12/24 06:00 [pubmed]
PHST- 2019/02/28 06:00 [medline]
PHST- 2017/12/24 06:00 [entrez]
PHST- 2017/12/22 00:00 [pmc-release]
AID - 10.1007/s10549-017-4617-6 [pii]
AID - 4617 [pii]
AID - 10.1007/s10549-017-4617-6 [doi]
PST - ppublish
SO  - Breast Cancer Res Treat. 2018 Apr;168(3):601-612. doi: 10.1007/s10549-017-4617-6. 
      Epub 2017 Dec 22.