Association between p53 Expression and Amount of Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer

  • Lee, Miseon (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, In Ah (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Heo, Sun-Hee (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Young-Ae (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) ;
  • Lee, Hee Jin (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.11.20
  • Accepted : 2019.02.08
  • Published : 2019.05.15


Background: Most triple-negative breast cancers (TNBCs) have a high histologic grade, are associated with high endoplasmic stress, and possess a high frequency of TP53 mutations. TP53 missense mutations lead to the production of mutant p53 protein and usually show high levels of p53 protein expression. Tumor-infiltrating lymphocytes (TILs) accumulate as part of the anti-tumor immune response and have a strong prognostic and predictive significance in TNBC. We aimed to elucidate the association between p53 expression and the amount of TILs in TNBC. Methods: In 678 TNBC patients, we evaluated TIL levels and expression of endoplasmic stress molecules. Immunohistochemical examination of p53 protein expression was categorized into three groups: no, low, and high expression. Results: No, low, and high p53 expression was identified in 44.1% (n=299), 20.1% (n=136), and 35.8% (n=243) of patients, respectively. Patients with high p53 expression showed high histologic grade (p<.001), high TIL levels (p=.009), and high expression of endoplasmic reticulum stress-associated molecules (p-eIF2a, p=.013; XBP1, p=.007), compared to patients with low p53 expression. There was no significant difference in disease-free (p=.406) or overall survival rates (p=.444) among the three p53 expression groups. Conclusions: High p53 expression is associated with increased expression of endoplasmic reticulum stress molecules and TIL influx.


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