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Expression of Myxovirus Resistance A (MxA) Is Associated with Tumor-Infiltrating Lymphocytes in Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Breast Cancers

  • Lee, So Jeong (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Hwang, Cheong-Soo (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Kim, Young-Keum (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Lee, Hyun Jung (Department of Pathology, Pusan National University Yangsan Hospital) ;
  • Ahn, Sang-Jeong (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Shin, Nari (Department of Pathology, Pusan National University Yangsan Hospital) ;
  • Lee, Jung Hee (Department of Pathology, Pusan National University Yangsan Hospital) ;
  • Shin, Dong Hoon (Department of Pathology, Pusan National University Yangsan Hospital) ;
  • Choi, Kyung Un (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Park, Do Youn (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Lee, Chang Hun (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Huh, Gi Young (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital) ;
  • Sol, Mi Young (Department of Pathology, Pusan National University Yangsan Hospital) ;
  • Lee, Hee Jin (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Gong, Gyungyub (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jee Yeon (Department of Pathology, Pusan National University Yangsan Hospital) ;
  • Kim, Ahrong (Department of Pathology, BioMedical Research Institute, Pusan National University Hospital)
  • Received : 2016.03.08
  • Accepted : 2016.06.16
  • Published : 2017.04.15

Abstract

Purpose The prognostic significance of tumor-infiltrating lymphocytes (TILs) has been determined in breast cancers. Interferons can affect T-cell activity through direct and indirect mechanisms. Myxovirus resistance A (MxA) is an excellent marker of interferon activity. Here,we evaluated TILs and MxA expression in human epidermal growth factor receptor 2 (HER2)-positive breast cancers. Materials and Methods Ninety cases of hormone receptor (HR)+/HER2+ tumors and 78 cases of HR-/HER2+ tumors were included. The TILs level was assessed using hematoxylin and eosin-stained full face sections, and MxA expression was evaluated by immunohistochemistry with a tissue microarray. Results MxA protein expression was significantly higher in tumors with high histologic grade (p=0.023) and high levels of TILs (p=0.002). High levels of TILs were correlated with high histological grade (p=0.001), negative lymphovascular invasion (p=0.007), negative lymph node metastasis (p=0.007), absence of HR expression (p < 0.001), abundant tertiary lymphoid structures (TLSs) around ductal carcinoma in situ (p=0.018), and abundant TLSs around the invasive component (p < 0.001). High levels of TILs were also associated with improved disease-free survival, particularly in HR-/HER2+ breast cancers. However, MxA was not a prognostic factor. Conclusion High expression of MxA in tumor cells was associated with high levels of TILs in HER2-positive breast cancers. Additionally, a high level of TILs was a prognostic factor for breast cancer, whereas the level of MxA expression had no prognostic value.

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