Accumulation of regulatory T cells in sentinel lymph nodes is a prognostic predictor in patients with node-negative breast cancer

Eur J Cancer. 2009 Aug;45(12):2123-31. doi: 10.1016/j.ejca.2009.03.024. Epub 2009 Apr 22.


It has been revealed that sentinel lymph nodes (SLNs) from patients with node-negative breast cancer involve RT-PCR detected micrometastases and isolated tumour cells. However, the prognostic significance of the pathologically undetectable micrometastases is still controversial. In this study, we evaluated Foxp3 positive regulatory T cells (Treg) in SLNs as host-side immune marker that has the potential to detect these micrometastases. In the analyses of training set (n=30), elevated Treg was strongly associated with the pathologically undetectable micrometastases. In the analyses of validation set (n=129) in patients with node-negative, relapse-free survival in patients with elevated Treg was significantly shorter than those with lower Treg (p=0.005). Furthermore, in multivariate analyses, elevated Treg was correlated with relapse-free survival (p=0.012). Our data indicate that Treg may increase in the microenvironment of SLNs along with pathologically undetectable micrometastases and is a prognostic predictor in patients with node-negative breast cancer.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / immunology*
  • Breast Neoplasms / immunology*
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / immunology*
  • Carcinoma, Ductal, Breast / pathology
  • Female
  • Forkhead Transcription Factors / analysis
  • Forkhead Transcription Factors / immunology*
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Lymph Nodes / immunology*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnosis
  • Lymphatic Metastasis / immunology
  • Middle Aged
  • Neoplasm Invasiveness
  • Predictive Value of Tests
  • Prognosis
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sentinel Lymph Node Biopsy
  • T-Lymphocytes, Regulatory / immunology*
  • T-Lymphocytes, Regulatory / pathology


  • Biomarkers, Tumor
  • FOXP3 protein, human
  • Forkhead Transcription Factors