Association of Clinico-Pathological Aspects and the CD4/CD8 Ratio in Breast Cancer

Background and Aims:The tumor immune infiltrating lymphocytes has been noted to be associated with prognosis and outcomes in HER2-Positive breast cancer. The aim of this study is to evaluate the clinical significance of peri-tumoral T Lymphocytes that express CD4 and CD8, and CD4/CD8 ratio with clinico-pathological aspects in breast cancer patients.Methods:The relationship between clinicopathological parameters and immune-reactivity was evaluated with Spearman s Chi squared test or Fisher’s exact test using median CD4/CD8 value as the cut-off. Expression of CD4 and CD8 was assessed by immunohistochemistry according to the manufacturer s protocols.Results:A total of 79 Breast cancer patients were involved, with mean age of 47.56 (± 9.27) years and age range of 24-65 years old. All of the cases were diagnosed as Invasive Ductal Carcinoma morphologic type. Overall 35 BCs were HER2 Positive (44.3%), and CD4/CD8 ratio was differ from 0.11 to 9.0, with median of 0.67. The CD4/CD8 ratio was significantly higher in HER2 Positive patients (P=0.000, Spearman s rho=0.53). While BCs with tumor size of 2-5 cm had higher CD4/CD8 ratio, but there was not any significant statistical difference (P=0.695, Spearman s rho=0.045). Also there was significant correlation between CD4/CD8 ratio and ER (P=0.014, Spearman s rho=0.276), and PR (P=0.014, Spearman s rho=0.276). Conclusion:The CD4/CD8 ratio at the peri-tumoral T Lymphocytes was significantly associated with positive HER2, whereas this association was not seen with the CD4/CD8 ratio and tumor size. Incorporating the quantity of the pre-existing immune response with other prognostic clinical pathological factors, such as tumor size and nodal status, will allow clinicians to better estimate long-term survival after breast cancer diagnosis.

Keywords:

Breast Cancer , Expression , HER2 , CD4 , CD8