KEY TAKEAWAYS
- The study aimed to investigate the correlation between US and MRI features and CD8+-TIL levels in HER2+ BC.
- Researchers noticed that US features and ADC values can estimate CD8+-TIL levels in HER2+ BC, aiding clinical decisions.
The level of tumor-infiltrating lymphocytes (TILs) in human epidermal growth factor receptor type 2 (HER2)-positive (+) breast cancer (BC) is positively correlated with pathological complete response.
Yuhong Fan and the team aimed to assess the correlation between these imaging features and CD8+-TIL levels to develop a reliable, non-invasive predictive tool.
They performed an inclusive analysis of 155 consecutive women with HER2+ BC in this retrospective study. Patients were divided into two groups based on CD8+-TIL levels: CD8+-TILlow (< 35%) and CD8+-TILhigh (≥ 35%). Ultrasound (US) and magnetic resonance imaging (MRI) features were evaluated using the BI-RADS lexicon, and the apparent diffusion coefficient (ADC) value was calculated with RadiAnt software.
Univariate and multivariate analyses identified the optimal US and MRI features for predicting CD8+-TIL levels. The diagnostic performance of US and MRI features was compared using receiver operating characteristic analysis and the Delong test. Additionally, the implementation of a nomogram was proposed to enhance clinical utility.
The univariate analysis of US features showed significant differences in shape, orientation, and posterior echo between the 2 groups; however, there were no significant differences in margins, internal echo, and microcalcification. Multifactorial analysis revealed that shape, orientation, and posterior echo were independent risk factors, with odds ratios of 11.62, 2.70, and 0.16, respectively.
In terms of MRI features, ADC was an independent predictor of CD8+-TIL levels. These 3 US features and the ADC performed well, with area under the curve (AUC) values of 0.802 and 0.705, respectively. The combination of US and ADC values had higher predictive efficacy (AUC = 0.888) than either US or ADC alone (P = 0.009, US_ADC vs. US; P < 0.001, US_ADC vs. ADC).
The study concluded that US features (shape, orientation, and posterior echo) and ADC value may be valuable tools for estimating CD8+-TIL levels in HER2+ BC. The nomogram developed from these imaging features could assist clinicians in making more informed treatment decisions.
This study was supported by the Innovation Ability Enhancement Project of Daping Hospital – Multimodal ultrasound in BI-RADS category 4 breast mass grading diagnosis and prognostic assessment of breast cancer and the Natural Science Foundation of Chongqing, China.
Source: https://pubmed.ncbi.nlm.nih.gov/38700366/
Fan Y, Li X, Zhong P, et al. (2024). “Radiological Features for Predicting the Status of CD8-Positive Lymphocytes in HER2 Positive Breast Cancer.” Balkan Med J. 2024 May 3;41(3):213-221. doi: 10.4274/balkanmedj.galenos.2024.2024-2-64. PMID: 38700366; PMCID: PMC11077930.
