Prognostic Value of Tumor Infiltrating Lymphocytes in Luminal B Breast Cancer Based on Multiphoton Microscopy

Area of Science:

• Oncology
• Medical Imaging
• Pathology

Background:

• Luminal B breast cancer is a heterogeneous subtype requiring precise prognostic markers.
• Tumor-infiltrating lymphocytes (TILs) are increasingly recognized for their role in anti-tumor immunity and prognosis.
• Multiphoton microscopy (MPM) offers advanced imaging capabilities for cellular analysis without staining.

Purpose of the Study:

• To investigate the prognostic value of TILs in luminal B breast cancer using MPM.
• To develop and validate a predictive model for 5-year disease-free survival (DFS).
• To assess the added value of TILs-score to existing clinical-pathological models.

Main Methods:

• Unlabeled MPM images were acquired from 213 luminal B breast cancer patients.
• TILs frequency was quantified, and a TILs-score was derived using ridge regression.
• A nomogram model integrating TILs-score and CLI-score was developed and validated.

Main Results:

• The MPM-based TILs-score demonstrated significant prognostic value for 5-year DFS.
• The integrated nomogram model showed improved predictive performance compared to the CLI-score model alone.
• In the training cohort, AUC increased from 0.740 to 0.830 and HR from 5.31 to 7.24.
• In the validation cohort, AUC increased from 0.716 to 0.822 and HR from 3.08 to 5.01.

Conclusions:

• MPM-based TILs-score is a robust prognostic biomarker in luminal B breast cancer.
• The integrated nomogram model enhances prediction of disease-free survival.
• These findings support the potential for TILs-score in guiding tailored treatment protocols for luminal B breast cancer.