Studies on Tumour Infiltrating Lymphocytes in Medullary Carcinoma of The Breast: Tumour Infiltrating on MBC Case
Ika Nurlaila
Jun 2013 · GRIN Verlag
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100
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There has been an increase in the incidence of breast cancer in Brunei Darussalam. The types of predominant breast cancers were ductal (84.9%), lobular (5.5%), malignant phyllodes (4.4%), papillary (0.7%) and ‘others’ (4.6%). Of all types of breast cancers, medullary breast carcinoma (MBC), a form of ductal carcinoma, is known to have a good prognosis. Morphologically, MBC is characterized by a well-circumscribed, syncytial growth pattern and abundant infiltration of lymphocytes. Further, MBC is sub-classified into Typical Medullary Carcinoma (TMC) and Atypical Medullary Carcinoma (AMC). This study attempted to determine the differences between TMC and AMC in regard to their histological appearances, number of CD8+ Cytotoxic Lymphocytes (CTLs) and the numbers of apoptotic cells that triggered by the direct contact among lymphocytes and tumour cells. Samples were obtained from Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Brunei Darussalam, in the form of Formalin Fixed Paraffin Embedded (FFPE) blocks. The tissues were treated with (1) Hematoxylin and Eosin (H&E) staining,(2) immunohistochemistry and (3) double staining immunofluorescence. The results from H&E staining were explained descriptively. The presence of CD8+ CTLs are described as percentage of positive cells per total number of lymphocytes whereas the presence of apoptotic cells was described using percentage of positive apoptotic cells per total numbers of lymphocytes or tumour cells, depending on the type of apoptosis-undergoing cell. These percentages were tabulated and statistically analysed using non-parametric Mann-Whitney U test. The results from immunohistochemistry showed that in lymphocytic tract, there was no significant difference between expression number of CD8+ CTLs in TMC and AMC (P=0.121), whereas in the tumour nest, TMC samples showed statistically significant higher expression of CD8+ CTLs compared to that of AMC samples (P=0.020). In terms of apoptotic cell count, AMC samples tended to express more apoptotic lymphocytes whereas TMC samples tended to express more apoptotic tumour cells, however, they were not significantly different: P=0.46 and P=1, respectively. Although statistically insignificant, the trend of apoptotic occurrence in TMC and AMC could be highlighted. The results support the occurrence of CD8+ CTL-mediated tumour immunity in TMC and tumour evasion of immunity in AMC. The results are consistent with TMC having more favourable prognosis than AMC.
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