Clinicopathological Correlates of High Stromal Tumor-infiltrating Lymphocytes in Luminal Breast Cancer: A Real-world Study
Journal of Oncological Science, cilt.12, sa.2, ss.247-252, 2026 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 12 Sayı: 2
- Basım Tarihi: 2026
- Doi Numarası: 10.37047/jos.galenos.2026.2026-3-11
- Dergi Adı: Journal of Oncological Science
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.247-252
- Anahtar Kelimeler: Breast cancer, disease-free survival, Ki-67, stromal tumor-infiltrating lymphocytes, tumor microenvironment
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Ankara Üniversitesi Adresli: Evet
Özet
Objective: The prognostic role of stromal tumor-infiltrating lymphocytes (sTIL) is well recognized in triple-negative and human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC), but their meaning in hormone receptor-positive, HER2-negative tumors is still debated. In luminal BC, lymphocytic infiltration may reflect biologically aggressive disease rather than an effective antitumor response. We investigated clinicopathological factors associated with high sTIL and examined their relationships with disease-free survival (DFS) in an early-stage luminal BC cohort treated in routine clinical practice. Material and Methods: This retrospective single-center study included 120 patients with early-stage estrogen receptor-positive, HER2-negative BC who were treated surgically between 2017 and 2021. Hematoxylin and eosin-stained slides were used to evaluate sTIL in accordance with International TILs Working Group recommendations. A 10% cut-off was used to define low-sTIL and high-sTIL categories. The relationship between sTIL category and clinicopathological variables was tested in univariable analyses and then explored using multivariable logistic regression. DFS was analyzed using the Kaplan-Meier method and groups were compared with the log-rank test. Results: Twenty-three patients (19.2%) were classified as having high sTIL. In univariable analysis, high sTIL status was associated with grade 3 tumors, lymphovascular invasion, and Ki-67 ≥20%. In the adjusted model, Ki-67 >20% remained the only independent factor associated with high sTIL (odds ratio: 8.68; 95% confidence interval: 1.07-70.45; p=0.043). During a median follow-up of 56.5 months, DFS did not differ significantly between patients with low and high sTIL (p=0.37); however, the high-sTIL group showed a numerically longer DFS. Conclusion: In this real-world cohort of early-stage luminal BC, high sTIL density was most strongly associated with proliferative activity, but not with a statistically significant DFS benefit. These results suggest that immune infiltration in luminal tumors, when assessed by conventional pathology, may be interpreted primarily as a feature of aggressive tumor biology rather than a consistent marker of effective antitumor immunity.