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Pediatric cancer
Malignant Hepatocellular Neoplasm, Not Otherwise Specified, Displays Poorer Chemoresponsiveness and Postoperative Prognosis Than Hepatoblastoma
In Hye Song, Sujin Gang, Hee Mang Yoon, Pyeong Hwa Kim, Bokyung Ahn, Jihun Kim, Deok Hoon Kim, Jung-Man Namgoong, Kyung-Nam Koh
Cancer Res Treat. 2026;58(2):642-655.   Published online May 12, 2025
DOI: https://doi.org/10.4143/crt.2025.117
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Malignant hepatocellular neoplasm, not otherwise specified (HCN-NOS) is a provisional diagnostic entity, characterised by intermediate or a combination of hepatoblastoma and pediatric hepatocellular carcinoma (p-HCC) features. We compared the characteristics of HCN-NOS with hepatoblastoma and p-HCC.
Materials and Methods
The records of 148 pediatric patients diagnosed with hepatocellular malignancy after resection were retrieved from the institutional database. Clinical parameters and histopathology slides were reviewed to re-establish each patient’s diagnosis. Molecular analyses were conducted in 37 patients.
Results
Patients were profiled as 21 (14.2%) with HCN-NOS, 109 (73.6%) with hepatoblastoma, and 18 (12.2%) with p-HCC. The median age was 8.6 years in HCN-NOS, 1.2 years in hepatoblastoma, and 7.9 years in p-HCC. Background liver disease was frequently observed in p-HCC (11/18, 61%) but infrequent in HCN-NOS (4/21, 19%) and hepatoblastoma (4/109, 3.7%). HCN-NOS presented with a more advanced PRETEXT stage (p=0.012), metastasis (p < 0.001), and lymphovascular invasion (p < 0.001) than hepatoblastoma and p-HCC. Patients with HCN-NOS received longer cycles of preoperative chemotherapy; however, they reported a lower decrease in serum alpha-fetoprotein and tumor size than hepatoblastoma (p=0.043, p=0.004, and p=0.044, respectively). HCN-NOS was an independent poor prognostic factor for event-free survival (hazard ratio, 4.968; 95% confidence interval, 2.004 to 12.32; p < 0.001).
Conclusion
The possibility of HCN-NOS should be considered in pediatric patients with liver cancer, especially those ≥ 5 years old with no background liver disease. Because HCN-NOS exhibits poor chemoresponsiveness and unfavourable postoperative prognosis, liver transplantation should be strongly considered.

Citations

Citations to this article as recorded by  
  • Conversion Hepatectomy After New FP Therapy for Malignant Hepatocellular Neoplasm, Not Otherwise Specified: A Case Report
    Etsuko Moriyama, Hironori Koga, Takashi Niizeki, Hideki Iwamoto, Shigeo Shimose, Tomotake Shirono, Takahiko Tokushige, Masahito Nakano, Ryoko Kuromatsu, Toru Goto, Masaki Honda, Taizo Hibi, Yoshiki Mikami, Reiichiro Kondo, Jun Akiba, Takumi Kawaguchi
    Hepatology Research.2026; 56(6): 1047.     CrossRef
  • 3,374 View
  • 171 Download
  • 1 Web of Science
  • 1 Crossref
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Gastrointestinal cancer
Presence of RB1 or Absence of LRP1B Mutation Predicts Poor Overall Survival in Patients with Gastric Neuroendocrine Carcinoma and Mixed Adenoneuroendocrine Carcinoma
In Hye Song, Bokyung Ahn, Young Soo Park, Deok Hoon Kim, Seung-Mo Hong
Cancer Res Treat. 2025;57(2):492-506.   Published online September 27, 2024
DOI: https://doi.org/10.4143/crt.2024.667
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Neuroendocrine carcinomas (NECs) of the stomach are extremely rare, but fatal. However, our understanding of the genetic alterations in gastric NECs is limited. We aimed to evaluate genomic and clinicopathological characteristics of gastric NECs and mixed adenoneuroendocrine carcinomas (MANECs).
Materials and Methods
Fourteen gastric NECs, three gastric MANECs, and 1,381 gastric adenocarcinomas were retrieved from the departmental next-generation sequencing database between 2017 and 2022. Clinicopathological parameters and next-generation sequencing test results were retrospectively collected and reviewed.
Results
Gastric NECs and MANECs frequently harbored alterations of TP53, RB1, SMARCA4, RICTOR, APC, TOP1, SLX4, EGFR, BRCA2, and TERT. In contrast, gastric adenocarcinomas exhibited alterations of TP53, CDH1, LRP1B, ARID1A, ERBB2, GNAS, CCNE1, NOTCH, and MYC. Mutations of AKT3, RB1, and SLX4; amplification of BRCA2 and RICTOR; and deletion of ADAMTS18, DDX11, KLRC3, KRAS, MAX, NFKBIA, NUDT7, and RB1 were significantly more frequent in gastric NECs and MANECs than in gastric adenocarcinomas. The presence of LRP1B mutation was significantly associated with longer overall survival (OS), whereas RB1 mutation and advanced TNM stage were associated with shorter OS.
Conclusion
We identified frequently mutated genes and potential predictors of survival in patients with gastric NECs and MANECs.

Citations

Citations to this article as recorded by  
  • Malignant Hepatocellular Neoplasm, Not Otherwise Specified, Displays Poorer Chemoresponsiveness and Postoperative Prognosis Than Hepatoblastoma
    In Hye Song, Sujin Gang, Hee Mang Yoon, Pyeong Hwa Kim, Bokyung Ahn, Jihun Kim, Deok Hoon Kim, Jung-Man Namgoong, Kyung-Nam Koh
    Cancer Research and Treatment.2026; 58(2): 642.     CrossRef
  • Intraductal Papillary Squamous Neoplasm (IPSN) of the Pancreas: Histological and Molecular Characterization of a Novel and Distinct Intraductal Cancer Precursor
    Michele Bevere, Antonio Pea, Volkan Adsay, Olca Basturk, Lodewijk A. Brosens, Irene Esposito, Ralph H. Hruban, David Klimstra, Seung-Mo Hong, Aatur D. Singhi, Seung Soo Lee, Paola Mattiolo, Davide Pasini, Andrea Mafficini, Paola Piccoli, Serena Pedron, Ca
    Modern Pathology.2026; 39(7): 101011.     CrossRef
  • Mixed adenoneuroendocrine carcinoma of the gallbladder: a case report and literature review
    Zhenghui Sui, Wei Wang, De Zhang, Yifan Sun, Jiajing Li, Xingwei Gu, Ganggang Miao
    Frontiers in Oncology.2026;[Epub]     CrossRef
  • Hepatoid adenocarcinoma of the stomach and non-hepatoid alpha-fetoprotein-producing gastric cancer exhibit a high degree of molecular similarity
    Liqiao Chen, Xuesong Yang, Peiyu Zhu, Han Bao, Yan Wu, Ke Ji, Ji Zhang, Xiaojiang Wu, Kai Zhou, Jieli Xu, Jiatian Tang, Anqiang Wang, Zhaode Bu
    Cellular Oncology.2025;[Epub]     CrossRef
  • 5,164 View
  • 142 Download
  • 2 Web of Science
  • 4 Crossref
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Breast cancer
Diagnostic Assessment of Deep Learning Algorithms for Frozen Tissue Section Analysis in Women with Breast Cancer
Young-Gon Kim, In Hye Song, Seung Yeon Cho, Sungchul Kim, Milim Kim, Soomin Ahn, Hyunna Lee, Dong Hyun Yang, Namkug Kim, Sungwan Kim, Taewoo Kim, Daeyoung Kim, Jonghyeon Choi, Ki-Sun Lee, Minuk Ma, Minki Jo, So Yeon Park, Gyungyub Gong
Cancer Res Treat. 2023;55(2):513-522.   Published online September 6, 2022
DOI: https://doi.org/10.4143/crt.2022.055
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Assessing the metastasis status of the sentinel lymph nodes (SLNs) for hematoxylin and eosin–stained frozen tissue sections by pathologists is an essential but tedious and time-consuming task that contributes to accurate breast cancer staging. This study aimed to review a challenge competition (HeLP 2019) for the development of automated solutions for classifying the metastasis status of breast cancer patients.
Materials and Methods
A total of 524 digital slides were obtained from frozen SLN sections: 297 (56.7%) from Asan Medical Center (AMC) and 227 (43.4%) from Seoul National University Bundang Hospital (SNUBH), South Korea. The slides were divided into training, development, and validation sets, where the development set comprised slides from both institutions and training and validation set included slides from only AMC and SNUBH, respectively. The algorithms were assessed for area under the receiver operating characteristic curve (AUC) and measurement of the longest metastatic tumor diameter. The final total scores were calculated as the mean of the two metrics, and the three teams with AUC values greater than 0.500 were selected for review and analysis in this study.
Results
The top three teams showed AUC values of 0.891, 0.809, and 0.736 and major axis prediction scores of 0.525, 0.459, and 0.387 for the validation set. The major factor that lowered the diagnostic accuracy was micro-metastasis.
Conclusion
In this challenge competition, accurate deep learning algorithms were developed that can be helpful for making a diagnosis on intraoperative SLN biopsy. The clinical utility of this approach was evaluated by including an external validation set from SNUBH.

Citations

Citations to this article as recorded by  
  • Detection of metastatic breast carcinoma in sentinel lymph node frozen sections using an artificial intelligence-assisted system
    Chia-Ping Chang, Chih-Yi Hsu, Hsiang Sheng Wang, Peng-Chuna Feng, Wen-Yih Liang
    Pathology - Research and Practice.2025; 267: 155836.     CrossRef
  • Value of frozen section to tailor surgical staging in apparent early-stage epithelial ovarian cancer
    Stefano Di Berardino, Nicolò Bizzarri, Marianna Ciancia, Francesca Moro, Belen Padial Urtueta, Claudia Marchetti, Gian Franco Zannoni, Giovanni Scambia, Anna Fagotti
    International Journal of Gynecological Cancer.2025; : 101746.     CrossRef
  • Comparing the diagnostic efficacy of optical coherence tomography and frozen section for margin assessment in breast-conserving surgery: a meta-analysis
    Shishun Fan, Huirui Zhang, Zhenyu Meng, Ang Li, Yuqing Luo, Yueping Liu
    Journal of Clinical Pathology.2024; 77(8): 517.     CrossRef
  • Intraoperative Margin Assessment in Breast Conservation Surgery: A Necessity or a Luxury?
    Srijan Shukla, Nisha Hariharan
    Annals of Surgical Oncology.2023; 30(9): 5314.     CrossRef
  • 10,934 View
  • 240 Download
  • 5 Web of Science
  • 4 Crossref
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The Association of Estrogen Receptor Activity, Interferon Signaling, and MHC Class I Expression in Breast Cancer
In Hye Song, Young-Ae Kim, Sun-Hee Heo, Won Seon Bang, Hye Seon Park, Yeon ho Choi, Heejae Lee, Jeong-Han Seo, Youngjin Cho, Sung Wook Jung, Hee Jeong Kim, Sei Hyun Ahn, Hee Jin Lee, Gyungyub Gong
Cancer Res Treat. 2022;54(4):1111-1120.   Published online December 21, 2021
DOI: https://doi.org/10.4143/crt.2021.1017
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The expression of major histocompatibility complex class I (MHC I) has previously been reported to be negatively associated with estrogen receptor (ER) expression. Furthermore, MHC I expression, level of tumor-infiltrating lymphocytes (TILs), and expression of interferon (IFN) mediator MxA are positively associated with one another in human breast cancers. This study aimed to investigate the mechanisms of association of MHC I with ER and IFN signaling.
Materials and Methods
The human leukocyte antigen (HLA)-ABC protein expression was analyzed in breast cancer cell lines. The expressions of HLA-A and MxA mRNAs were analyzed in MCF-7 cells in Gene Expression Omnibus (GEO) data. ER and HLA-ABC expressions, Ki-67 labeling index and TIL levels in tumor tissue were also analyzed in ER+/ human epidermal growth factor receptor 2 (HER2)- breast cancer patients who randomly received either neoadjuvant chemotherapy or estrogen modulator treatment followed by resection.
Results
HLA-ABC protein expression was decreased after β-estradiol treatment or hESR-GFP transfection and increased after fulvestrant or IFN-γ treatment in cell lines. In GEO data, HLA-A and MxA expression was increased after ESR1 shRNA transfection. In patients, ER Allred score was significantly lower and the HLA-ABC expression, TIL levels, and Ki-67 were significantly higher in the estrogen modulator treated group than the chemotherapy treated group.
Conclusion
MHC I expression and TIL levels might be affected by ER pathway modulation and IFN treatment. Further studies elucidating the mechanism of MHC I regulation could suggest a way to boost TIL influx in cancer in a clinical setting.

Citations

Citations to this article as recorded by  
  • The Immunoregulatory Roles of ERα in Breast Cancer: Mechanisms, Crosstalk, and Therapeutic Insights
    Afsoon Dehghani
    Journal of Cancer Prevention.2026; 31(1): 1.     CrossRef
  • Identifying Safeguards Disabled by Epstein-Barr Virus Infections in Genomes From Patients With Breast Cancer: Chromosomal Bioinformatics Analysis
    Bernard Friedenson
    JMIRx Med.2025; 6: e50712.     CrossRef
  • Progesterone receptor-dependent downregulation of MHC class I promotes tumor immune evasion and growth in breast cancer
    Julio C Tinoco, Harmony I Saunders, Lauryn Rose Werner, Xiaopeng Sun, Eilidh I Chowanec, Amanda Heard, Prabhakar Chalise, Jeffery M Vahrenkamp, Andrea E Wilson, Cong-Xiao Liu, Gangjun Lei, Junping Wei, Hugo Cros, Hisham Mohammed, Melissa Troester, Charles
    Journal for ImmunoTherapy of Cancer.2025; 13(3): e010179.     CrossRef
  • Neoadjuvant Chemotherapy Efficacy in Breast Cancer: Insights from Magnetic Resonance Imaging Compilation (MAGIC)
    Honghong Wu, Zebo Huang, Jie Wang
    Academic Radiology.2025; 32(8): 4369.     CrossRef
  • Prenatal Bisphenol B Exposure Induces Adult Male Offspring Reproductive Dysfunction via ERα Inhibition-Triggered MHC I-Mediated Testicular Immunological Responses
    Nannan Chen, Xiaotian Li, Shenrui Zhou, Xin Peng, Senlin Xue, Yuetong Liu, Tingwang Jiang, Wei Yan
    Toxics.2025; 13(6): 423.     CrossRef
  • The untapped potential of radiation and immunotherapy for hormone receptor-positive breast cancer
    Matthew Fenton, Miki Yoneyama, Erik Wennerberg, Tom Lund, Andrew Tutt, Alan Melcher, Sandra Demaria, Navita Somaiah
    npj Breast Cancer.2025;[Epub]     CrossRef
  • Dendrimer-Mediated Delivery Enhances Therapeutic Efficacy in Triple-Negative Breast Cancer
    Anunay James Pulukuri, Anubhav Dhull, Aqib Iqbal Dar, Anu Rani, Rishi Sharma, Clifford E. Berkman, Anjali Sharma
    Biomacromolecules.2025; 26(9): 5979.     CrossRef
  • Neoadjuvant Immunotherapy in Hormone Receptor-Positive Breast Cancer: From Tumor Microenvironment Reprogramming to Combination Therapy Strategies
    Zimei Tang, Tao Huang, Tinglin Yang
    International Journal of Molecular Sciences.2025; 26(23): 11596.     CrossRef
  • Toxic Epidermal Necrolysis and Steven–Johnson Syndrome During the Postpartum Period: A Literature Review with a Rare Case Presentation
    Natalia Katarzyna Mazur-Ejankowska, Maciej Ejankowski, Magdalena Emilia Grzybowska, Jakub Żółkiewicz, Ewa Gostkowska, Wioletta Barańska-Rybak, Dariusz Grzegorz Wydra
    Journal of Clinical Medicine.2025; 15(1): 17.     CrossRef
  • Estrogen receptor regulation of the immune microenvironment in breast cancer
    Conor McGuinness, Kara L. Britt
    The Journal of Steroid Biochemistry and Molecular Biology.2024; 240: 106517.     CrossRef
  • Bioinformatic-Experimental Screening Uncovers Multiple Targets for Increase of MHC-I Expression through Activating the Interferon Response in Breast Cancer
    Xin Li, Zilun Ruan, Shuzhen Yang, Qing Yang, Jinpeng Li, Mingming Hu
    International Journal of Molecular Sciences.2024; 25(19): 10546.     CrossRef
  • Hormone Receptor Signaling and Breast Cancer Resistance to Anti-Tumor Immunity
    Alexandra Moisand, Mathilde Madéry, Thomas Boyer, Charlotte Domblides, Céline Blaye, Nicolas Larmonier
    International Journal of Molecular Sciences.2023; 24(20): 15048.     CrossRef
  • 9,789 View
  • 196 Download
  • 11 Web of Science
  • 12 Crossref
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Challenge for Diagnostic Assessment of Deep Learning Algorithm for Metastases Classification in Sentinel Lymph Nodes on Frozen Tissue Section Digital Slides in Women with Breast Cancer
Young-Gon Kim, In Hye Song, Hyunna Lee, Sungchul Kim, Dong Hyun Yang, Namkug Kim, Dongho Shin, Yeonsoo Yoo, Kyowoon Lee, Dahye Kim, Hwejin Jung, Hyunbin Cho, Hyungyu Lee, Taeu Kim, Jong Hyun Choi, Changwon Seo, Seong il Han, Young Je Lee, Young Seo Lee, Hyung-Ryun Yoo, Yongju Lee, Jeong Hwan Park, Sohee Oh, Gyungyub Gong
Cancer Res Treat. 2020;52(4):1103-1111.   Published online June 30, 2020
DOI: https://doi.org/10.4143/crt.2020.337
AbstractAbstract PDFPubReaderePub
Purpose
Assessing the status of metastasis in sentinel lymph nodes (SLNs) by pathologists is an essential task for the accurate staging of breast cancer. However, histopathological evaluation of sentinel lymph nodes by a pathologist is not easy and is a tedious and time-consuming task. The purpose of this study is to review a challenge competition (HeLP 2018) to develop automated solutions for the classification of metastases in hematoxylin and eosin–stained frozen tissue sections of SLNs in breast cancer patients.
Materials and Methods
A total of 297 digital slides were obtained from frozen SLN sections, which include post–neoadjuvant cases (n = 144, 48.5%) in Asan Medical Center, South Korea. The slides were divided into training, development, and validation sets. All of the imaging datasets have been manually segmented by expert pathologists. A total of 10 participants were allowed to use the Kakao challenge platform for six weeks with two P40 GPUs. The algorithms were assessed in terms of the AUC (area under receiver operating characteristic curve).
Results
The top three teams showed 0.986, 0.985, and 0.945 AUCs for the development set and 0.805, 0.776, and 0.765 AUCs for the validation set. Micrometastatic tumors, neoadjuvant systemic therapy, invasive lobular carcinoma, and histologic grade 3 were associated with lower diagnostic accuracy.
Conclusion
In a challenge competition, accurate deep learning algorithms have been developed, which can be helpful in making frozen diagnosis of intraoperative sentinel lymph node biopsy. Whether this approach has clinical utility will require evaluation in a clinical setting

Citations

Citations to this article as recorded by  
  • Detection of metastatic breast carcinoma in sentinel lymph node frozen sections using an artificial intelligence-assisted system
    Chia-Ping Chang, Chih-Yi Hsu, Hsiang Sheng Wang, Peng-Chuna Feng, Wen-Yih Liang
    Pathology - Research and Practice.2025; 267: 155836.     CrossRef
  • Fusing Domains for Tumor Detection in Frozen Section Histopathology Using Joint Feature Alignment and Self-Knowledge Distillation
    Eunsu Kim, Yoo Jin Lee, Jonghyun Lee, Hyeseong Lee, D M Bappy, Sangjeong Ahn, Sung Hak Lee
    IEEE Access.2025; 13: 190745.     CrossRef
  • Diagnostic Assessment of Deep Learning Algorithms for Frozen Tissue Section Analysis in Women with Breast Cancer
    Young-Gon Kim, In Hye Song, Seung Yeon Cho, Sungchul Kim, Milim Kim, Soomin Ahn, Hyunna Lee, Dong Hyun Yang, Namkug Kim, Sungwan Kim, Taewoo Kim, Daeyoung Kim, Jonghyeon Choi, Ki-Sun Lee, Minuk Ma, Minki Jo, So Yeon Park, Gyungyub Gong
    Cancer Research and Treatment.2023; 55(2): 513.     CrossRef
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    Benjamin G. Gorman, Mark A. Lifson, Nahid Y. Vidal
    Journal of Cutaneous Pathology.2023; 50(9): 852.     CrossRef
  • Effectiveness of transfer learning for enhancing tumor classification with a convolutional neural network on frozen sections
    Young-Gon Kim, Sungchul Kim, Cristina Eunbee Cho, In Hye Song, Hee Jin Lee, Soomin Ahn, So Yeon Park, Gyungyub Gong, Namkug Kim
    Scientific Reports.2020;[Epub]     CrossRef
  • 11,535 View
  • 218 Download
  • 18 Web of Science
  • 5 Crossref
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Expression of Immunoproteasome Subunit LMP7 in Breast Cancer and Its Association with Immune-Related Markers
Miseon Lee, In Hye Song, Sun-Hee Heo, Young-Ae Kim, In Ah Park, Won Seon Bang, Hye Seon Park, Gyungyub Gong, Hee Jin Lee
Cancer Res Treat. 2019;51(1):80-89.   Published online February 26, 2018
DOI: https://doi.org/10.4143/crt.2017.500
AbstractAbstract PDFPubReaderePub
Purpose
In the presence of interferon, proteasome subunits are replaced by their inducible counterparts to form an immunoproteasome (IP) plays a key role in generation of antigenic peptides presented by MHC class I molecules, leading to elicitation of a T cell‒mediated immune response. Although the roles of IP in other cancers, and inflammatory diseases have been extensively studied, its significance in breast cancer is unclear.
Materials and Methods
We investigated the expression of LMP7, an IP subunit, and its relationship with immune system components in two breast cancer cohorts.
Results
In 668 consecutive breast cancer cohort, 40% of tumors showed high level of LMP7 expression, and tumors with high expression of LMP7 had more tumor-infiltrating lymphocytes (TILs) in each subtype of breast cancer. In another cohort of 681 triple-negative breast cancer patients cohort, the expression of LMP7 in tumor cells was significantly correlated with the amount of TILs and the expression of interferon-associated molecules (MxA [p < 0.001] and PKR [p < 0.001]), endoplasmic reticulum stress-associated molecules (PERK [p=0.012], p-eIF2a [p=0.001], and XBP1 [p < 0.001]), and damage-associated molecular patterns (HMGN1 [p < 0.001] and HMGB1 [p < 0.001]). Patients with higher LMP7 expression had better disease-free survival outcomes than those with no or low expression in the positive lymph node metastasis group (p=0.041).
Conclusion
Close association between the TIL levels and LMP7 expression in breast cancer indicates that better antigen presentation through greater LMP7 expression might be associated with more TILs.

Citations

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    Takayuki Kiuchi, Utano Tomaru, Akihiro Ishizu, Makoto Imagawa, Sari Iwasaki, Akira Suzuki, Noriyuki Otsuka, Yoshihito Ohhara, Ichiro Kinoshita, Yoshihiro Matsuno, Hirotoshi Dosaka-Akita, Masanori Kasahara
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Predictive Value of Tertiary Lymphoid Structures Assessed by High Endothelial Venule Counts in the Neoadjuvant Setting of Triple-Negative Breast Cancer
In Hye Song, Sun-Hee Heo, Won Seon Bang, Hye Seon Park, In Ah Park, Young-Ae Kim, Suk Young Park, Jin Roh, Gyungyub Gong, Hee Jin Lee
Cancer Res Treat. 2017;49(2):399-407.   Published online July 27, 2016
DOI: https://doi.org/10.4143/crt.2016.215
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The tertiary lymphoid structure (TLS) is an important source of tumor-infiltrating lymphocytes (TILs), which have a strong prognostic and predictive value in triple-negative breast cancer (TNBC). A previous study reported that the levels of CXCL13 mRNA expression were associated with TLSs, but measuring the gene expression is challenging in routine practice. Therefore, this study evaluated the MECA79-positive high endothelial venule (HEV) densities and their association with the histopathologically assessed TLSs in biopsy samples. In addition, the relationship of TLSs with the CXCL13 transcript levels and clinical outcomes were examined.
Materials and Methods
A total of 108 TNBC patients treated with neoadjuvant chemotherapy (NAC) were studied. The amounts of TILs and TLSs were measured histopathologically using hematoxylin and eosin–stained slides. The HEV densities and TIL subpopulations were measured by immunohistochemistry for MECA79, CD3, CD8, and CD20. CXCL13 mRNA expression levels using a NanoString assay (NanoString Technologies).
Results
The mean number of HEVs in pre-NAC biopsies was 12 (range, 0 to 72). The amounts of TILs and TLSs, HEV density, and CXCL13 expression showed robust correlations with each other. A lower pre-NAC clinical T stage, higher TIL and TLS levels, a higher HEV density, CD20-positive cell density, and CXCL13 expression were significant predictors of a pathologic complete response (pCR). Higher CD8-positive cell density and levels of CXCL13 expression were significantly associated with a better disease-free survival rate.
Conclusion
MECA79-positive HEV density in pre-NAC biopsies is an objective and quantitative surrogate marker of TLS and might be a valuable tool for predicting pCR of TNBC in routine pathology practice.

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