A RETROSPECTIVE STUDY OF BREAST CARCINOMA CORRELATING STAGE AND GRADE OF TUMOUR WITH CD4 EXPRESSION OF TUMOUR INFILTRATING LYMPHOCYTES

Abstract

Introduction: Tumour infiltrating lymphocytes (TILs) are an important component of the tumour microenvironment and are known to influence tumour progression, immune regulation, and clinical outcome in breast carcinoma. Among them, CD4-positive T lymphocytes play a major role in modulation of immune response. The present study was undertaken to evaluate CD4 tumour infiltrating lymphocytes and correlate their expression with established clinicopathological prognostic parameters in breast carcinoma.

Methods: This retrospective observational study included 23 cases of invasive ductal carcinoma of no special type treated with modified radical mastectomy data retrieved from archival histopathology records for two years in the department of pathology,Saveetha medical college. Immunohistochemical staining for CD4 was performed on formalin-fixed paraffin-embedded tissue sections. CD4⁺ tumour infiltrating lymphocytes were assessed in both intratumoural and stromal compartments and correlated with clinicopathological variables including tumour size, grade, stage, lymph node status, oestrogen receptor (ER), progesterone receptor (PR), and HER2/neu status. Statistical analysis was performed using Chi-square test, with p < 0.05 considered statistically significant.

Results: The mean age of patients was 49 ± 9.4 years, and the majority were females. Stromal CD4 tumour infiltrating lymphocytes constituted the predominant component of immune infiltration compared to intratumoural lymphocytes. A statistically significant association was observed between CD4 TILs and tumour size (p = 0.006), tumour stage (p = 0.026), and lymph node metastasis (p = 0.007). Increased CD4⁺ lymphocytic infiltration was observed in larger tumours, advanced-stage disease, and lymph node-positive cases. No significant association was found between CD4 TILs and tumour grade, lymphovascular invasion, ER, PR, or HER2/neu status.

Conclusion: The present study demonstrates that increased CD4 tumour infiltrating lymphocytes are associated with aggressive clinicopathological features in breast carcinoma, suggesting their potential role in tumour progression and prognostication.