Navegando por Palavras-chave "Complete pathological response"

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    Avaliação da resposta imune celular de mulheres com câncer de mama localmente avançado
    (Universidade Federal de São Paulo (UNIFESP), 2018-09-27) Moura, Jose Fernando do Prado [UNIFESP]; Melo, Analy Salles de Azevedo [UNIFESP]; Torres, Leuridan Cavalcante [UNIFESP]; http://lattes.cnpq.br/4973562538598237; http://lattes.cnpq.br/8922840487452492; http://lattes.cnpq.br/1354495849607971; Universidade Federal de São Paulo (UNIFESP)
    Breast cancer (BC) is the most frequent and the second leading cause of cancer death among women. The immune response in cancer in the development and prognosis of the cancer patient is the focus of current studies due to the new possibilities of treatment (immunotherapy). T lymphocytes contribute to tumor immunosurveillance indicating that the immune system influences the prognosis and response to chemotherapy. However, its clinical relevance is not fully established in breast cancer. Based in immunohistochemistry there are four BC subtypes: Luminal (A and B), HER2+ and Triple negative (TN).This study aimed to characterize the profile of circulating T, NKT cells and their subpopulations, in patients with locally advanced breast cancer. Two prospective cohorts of women with locally advanced breast cancer (n=82) and healthy controls (CTRL) (n=25) were analysed. Tumor subtype distribution was as follow: 31 Luminal, 20 HER2+ and 31 Triple-Negative. The peripheral blood was collected from the pacients before neoadjuvant chemotherapy. Immunophenotyping of the cell populations by flow cytometry was performed for analysis of the cellular immune response. Pathological complete response (pCR) was defined as the absence of invasive neoplasia in the surgical specimen (breast and axilla). The Mann Whitney test was used for analysis between the two groups and Kruskall-Wallys for analysis between three or more groups, using the program GraphPad Prism, v6.0. Patients with pCR showed lower % of lymphocytes TCD3+ (p=0.007), TCD4+ (p=0,02), CD4+/CD8+ ratio (p=0.02) and higher % of TCD8+ (p=0.01). The TCD8+naive/memory ratio was lower in TN than Luminal and CTRL. Regarding naïve T lymphocytes and memory, the TCD8+ naive / memory ratio was decreased in TN compared to Luminal and CTRL. Patients with pCR had reduced levels of TCD8 + memory and high CD4+ naive / memory and CD8+ naive / memory ratios (respectivally, p=0,003, p=0,01, p=0,02). Patients with BC (all subtypes) and TN subtype show reduced levels of CD161 + NKT cells compared to CTRL (p = 0.006 and p = 0.004, respectively). The NKT CD94 + were reduced in luminals when compared to HER2+ (p = 0.04), TN (p = 0.02) and CTRL (p = 0.005). There was an increase in % of total iNKT cells compared to CTRL (p <0.05). The % of CD4+CD8 + iNKT were reduced in the luminal (p = 0.01), HER2+ (p = 0.02) and TN (p = 0.001) subtypes compared to the CTRL. The iNKT CD4+/ CD8+ ratio were lower in Luminal compared to HER2+ (p = 0.02). There was an increase in % of iNKT CD8+ in Luminal compared to HER2+ (p = 0.003) and CTRL (p = 0.002) and higher in TN compared to HER2+ (p = 0.02) and CTRL (p = 0.01). No difference was observed when the iNKT subpopulations according to pCR. There is an association of the cellular immune response with the type of response to the treatment, and the analysis of the subpopulations of T lymphocytes in the peripheral blood is a good tool to predict response to neoadjuvant chemotherapy in patients with breast cancer.