Tumor-infiltrating lymphocytes (TILs) in surgical-specimen might be associated with host-cell mediated immunity, which could be partly reflected by blood cell counts from peripheries. We investigated whether peripheral blood cell counts are associated with TILs in 577 patients with breast cancer.
Between August 2016 and April 2018, we evaluated the percentage of stromal TILs in breast cancer patients who underwent primary surgery according to standardized methodology proposed by the international TIL Working Group. Lymphocyte-predominant breast cancer (LPBC) was defined as tumors having high TIL levels (≥ 50%). Blood cell counts including absolute neutrophil counts (ANC), absolute lymphocyte counts (ALC), percentages of ANC and ALC, and neutrophil-to-lymphocyte ratio (NLR) was obtained from pretreatment laboratory data.
Of 577 tumors, 99 (17.2%) was LPBC, and 478 (82.8%) was non-LBPC. When 5 markers of peripheral blood counts were compared, LPBC had a significantly higher mean ANC than non-LPBC (3,671 vs. 3,336; P = 0.004), but other means were not different. Further, in luminal/HER2-negative breast cancer, mean ANC of LPBC was still higher than that of non-LPBC (P = 0.025), whereas it tended to be higher in LPBC in other subtypes (P = 0.385 in HER2, P = 0.260 in TNBC).
Our results suggest that low peripheral ANC might be linked with LPBC, supporting the hypothesis that systemic immune cell counts might be associated with tumor-immune microenvironment. Further study on an association between peripheral ANC and tumor-associated neutrophil consisting tumor micromileu is warranted.
Clinical trial identification
Legal entity responsible for the study
The Institutional Review Boards of the Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
Has not received any funding.
All authors have declared no conflicts of interest.