Magnetic Resonance Imaging Features Associated with a High and Low Expression of Tumor-Infiltrating Lymphocytes: A Stratified Analysis According to Molecular Subtypes

• Published in: Cancers Vol. 15; no. 23; p. 5672
• Main Authors: Zhou, Jiejie, Jin, Yi, Miao, Haiwei, Lu, Shanshan, Liu, Xinmiao, He, Yun, Liu, Huiru, Zhao, Youfan, Zhang, Yang, Liu, Yan-Lin, Pan, Zhifang, Chen, Jeon-Hor, Wang, Meihao, Su, Min-Ying
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.11.2023
• Subjects: Adjuvant treatment; Biomarkers; Breast cancer; Cancer; Chemotherapy; Comparative analysis; Edema; ErbB-2 protein; Gene amplification; Immunotherapy; Lymphocytes; Magnetic resonance imaging; Medical prognosis; Medical research; Medicine, Experimental; Morphology; Normal distribution; Patients; Statistical analysis; Stroma; Tumor cells; Tumor-infiltrating lymphocytes; Tumors; Variance analysis; Working groups; breast cancer; tumor-infiltrating lymphocytes; magnetic resonance imaging; molecular subtype
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15235672

A total of 457 patients, including 241 HR+/HER2− patients, 134 HER2+ patients, and 82 TN patients, were studied. The percentage of TILs in the stroma adjacent to the tumor cells was assessed using a 10% cutoff. The low TIL percentages were 82% in the HR+ patients, 63% in the HER2+ patients, and 56% in the TN patients (p < 0.001). MRI features such as morphology as mass or non-mass enhancement (NME), shape, margin, internal enhancement, presence of peritumoral edema, and the DCE kinetic pattern were assessed. Tumor sizes were smaller in the HR+/HER2− group (p < 0.001); HER2+ was more likely to present as NME (p = 0.031); homogeneous enhancement was mostly seen in HR+ (p < 0.001); and the peritumoral edema was present in 45% HR+, 71% HER2+, and 80% TN (p < 0.001). In each subtype, the MR features between the high- vs. low-TIL groups were compared. In HR+/HER2−, peritumoral edema was more likely to be present in those with high TILs (70%) than in those with low TILs (40%, p < 0.001). In TN, those with high TILs were more likely to present a regular shape (33%) than those with low TILs (13%, p = 0.029) and more likely to present the circumscribed margin (19%) than those with low TILs (2%, p = 0.009).