The immune system plays a key role in tumor surveillance and escape. Recently, CD73 has been proposed as a prognostic biomarker associated with disease-free survival and overall survival in triple negative breast cancer (TNBC). In this study, we investigated the role of both CD73 expression and stromal tumor-infiltrating lymphocytes (TILs) in predicting the pathologic response of TNBC to neoadjuvant chemotherapy (NACT). We retrospectively analyzed CD73 immunohistochemical expression and stromal TILs on 61 consecutive biopsies from patients who received standard NACT. Twenty-three patients (38%) achieved pathologic complete response (pCR). TILs were present in the majority of biopsies (93%) with percentages ranging from 2 to 80%. High TILs (≥ 50%) were found in 30% of cases, and in this group, pCR was achieved in 76.5% of cases. Levels of TILs were associated with a better pathologic response only at univariate analysis (p = 0.037). The median value of CD73 expression on tumor cells was 40%. In 32 (52.5%) basal biopsies, CD73 expression was below or equal to median value ("low CD73"). A pCR was obtained in 53% of cases with "low CD73" and in 21% with high CD73, and this was statistically different both at univariate (p = 0.011) and multivariate (p = 0.014) analysis.Our results suggest that CD73 expression better predicts the response to NACT than TILs in TNBC. Characterization of both TILs and microenvironment could be a promising approach to personalize treatment.

中文翻译：

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三阴性乳腺癌中CD73的表达和对新辅助化疗的病理反应。

免疫系统在肿瘤监测和逃逸中起关键作用。最近，已提出CD73作为与三阴性乳腺癌（TNBC）的无病生存期和总体生存期相关的预后生物标志物。在这项研究中，我们调查了CD73表达和间质肿瘤浸润淋巴细胞（TILs）在预测TNBC对新辅助化疗（NACT）的病理反应中的作用。我们回顾性分析了连续61例接受标准NACT的患者的活检组织中CD73免疫组织化学表达和基质TIL。23例患者（38％）达到了病理完全缓解（pCR）。TIL存在于大多数活检组织中（93％），百分比范围为2％至80％。在30％的病例中发现高TIL（≥50％），在该组中，在76.5％的病例中达到了pCR。仅在单变量分析中，TILs水平与更好的病理反应相关（p = 0.037）。肿瘤细胞上CD73表达的中值为40％。在32例（52.5％）基底活检中，CD73表达低于或等于中值（“低CD73”）。53％的“低CD73”患者和21％的高CD73患者获得了pCR，这在单变量（p = 0.011）和多变量（p = 0.014）分析中均存在统计学差异。我们的结果表明CD73表达比TNBC中的TIL更能预测对NACT的反应。TIL和微环境的表征可能是个性化治疗的有前途的方法。CD73表达低于或等于中值（“低CD73”）。53％的“低CD73”患者和21％的高CD73患者获得了pCR，这在单变量（p = 0.011）和多变量（p = 0.014）分析中均存在统计学差异。我们的结果表明CD73表达比TNBC中的TIL更能预测对NACT的反应。TIL和微环境的表征可能是个性化治疗的有前途的方法。CD73表达低于或等于中值（“低CD73”）。53％的“低CD73”患者和21％的高CD73患者获得了pCR，这在单变量（p = 0.011）和多变量（p = 0.014）分析中均存在统计学差异。我们的结果表明CD73表达比TNBC中的TIL更能预测对NACT的反应。TIL和微环境的表征可能是个性化治疗的有前途的方法。