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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2019.02.08    [Epub ahead of print]
Association between p53 Expression and Amount of Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer
Miseon Lee1, In A. Park1, Sun-Hee Heo1,2, Young-Ae Kim1,2, Gyungyub Gong1, Hee J. Lee1
1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Asan Center for Cancer Genome Discovery, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Hee J. Lee ,Tel: 82-2-3010-5889, Fax: 82-2-472-7898, Email: backlila@gmail.com
Received: November 20, 2018;  Revised: January 7, 2019  Accepted: February 8, 2019.  Published online: March 11, 2019.

Most triple-negative breast cancers (TNBCs) have a high histological grade, are associated with high endoplasmic stress, and possess a high frequency of TP53 mutations. TP53 missense mutations lead to the production of mutant p53 protein and usually show high levels of p53 protein expression. Tumor-infiltrating lymphocytes (TILs) accumulate as part of the anti-tumor immune response and have a strong prognostic and predictive significance in TNBC. We aimed to elucidate the association between p53 expression and the amount of TILs in TNBC.
In 678 TNBC patients, we evaluated TIL levels and expression of endoplasmic stress molecules. Immunohistochemical examination of p53 protein expression was categorized into three groups: no, low, and high expression.
No, low, and high p53 expression was identified in 44.1% (n = 299), 20.1% (n = 136), and 35.8% (n = 243) of patients, respectively. Patients with high p53 expression showed high histologic grade (p < 0.001), high TIL levels (p = 0.009), and high expression of endoplasmic reticulum stress-associated molecules [p-eIF2a (p = 0.013) and XBP1 (p = 0.007)], compared to patients with low p53 expression. There was no significant difference in disease-free (p = 0.406) or overall survival rates (p = 0.444) among the three p53 expression groups.
High p53 expression is associated with increased expression of endoplasmic reticulum stress molecules and TIL influx, which could facilitate understanding of TIL influx mechanisms.
Key Words: p53; Breast cancer; Tumor-infiltrating lymphocyte