Clinicopathological significance of PTEN,Twist1 and PD1^(+)tumor infiltration lymphocytes in triple negative breast cancer

Objective:To study the prognostic features and relationships of PTEN,Twist1 and PD1+tumor infiltration lymphocytes(TILPD1)in triple negative breast cancer(TNBC)by retrospectively analyzing clinicopathological data from patients and immunohistochemical methods.Methods:Formalin-fixed paraffin-embedded(FFPE)specimens of 76 TNBC patients and 46 other subtypes breast cancer patients(NTNBC)were collected in the first affiliated hospital of Bengbu Medical College.These specimen were then immunohistochemically evaluated for expression of PTEN,Twist1 and TILPD1.We also collected clinicopathological features and prognostic data from these patients,who have been followed up regularly through telephone until now.Statistical methods were taken to correlate expression level of different biomarkers and the clinical data.Results:Compared with NTNBC patients,degree of tumor infiltrating lymphocytes and Twist1 expression was higher in TNBC patients.In TNBC tissues,PTEN was negatively correlated with Twist1 and TILPD1 expression,Twist1 was positively correlated with TILPD1 expression,and TILPD1 expression was significantly positively correlated with tumor stromal TIL infiltration(P=0.012,0.031,0.019,0.035).In addition,PTEN was negatively correlated with the clinical stage of tumor(P=0.002),and was also correlated with TIL infiltration,tumor metastasis rate and histological grade.Univariate and multivariate survival analyses showed that patients with lower TNM grade,no lymph node or distant metastasis had better clinical prognosis,while PTEN deficiency and TILPD1 overexpression were independent risk factors of patients with TNBC.Conclusion:Our results suggest that PTEN downregulation and TILPD1 overexpression may predict an unfavorable prognosis for TNBC patients.Thus,these two biomarkers present the potential as two prognostic predictor for TNBC.