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Background <p>Tumor-infiltrating lymphocytes (TILs) are recognized as prognostic biomarkers. However, inconsistent TIL scores across breast cancer stages, and data are scarce for Ethiopian patients. Thus, this study evaluated TIL scores across breast cancer stages in Northwest Ethiopia.</p> Methods <p>A cross-sectional study was conducted from 20 June 2024 to 19 June 2025. Using consecutive sampling, 62 breast cancer patients were enrolled, and their socio-demographic and clinicopathological data were collected using questionnaires and chart reviews. Formalin-fixed, paraffin-embedded tissue sections were stained with hematoxylin and eosin, and stromal TILs were evaluated according to the International TIL Working Group guidelines. Data were analyzed using SPSS version 27. Median TILs across clinicopathological variables were assessed using Kruskal-Wallis and Mann-Whitney U tests. Spearman correlation assessed the association of TIL scores and clinicopathological variables. <i>P</i> ≤ 0.05 was considered statistically significant.</p> Results <p>Low TIL scores were observed in 76.5% of stage II cases, whereas high TIL scores were observed in 54.5% of stage IV cases. Median TIL percentages in stage IV (48%) and III (33%) were significantly higher than in stage II (7%), and in N2–N3 (33%) than in N0–N1 (9%) (<i>p</i> &lt; 0.001). Moreover, the median TIL percentage in grade III (48%) was higher than in grade I (9%) (<i>p</i> = 0.028). TILs were positively correlated with TNM stage, lymph node stage, and grade.</p> Conclusions <p>A positive correlation was found between TIL score and TNM stage. Intermediate and high TIL scores were common in advanced stages, whereas low TIL scores were prevalent in early stages. The findings suggest that advanced tumors may harbor higher mutation burdens and immunogenicity. Future research should explore the molecular subtypes of immune profiles.</p>

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Evaluation of tumor-infiltrating lymphocytes across breast cancer stages at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月22日

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  • Emiyamrew Getnet,
  • Gashaw Adane,
  • Ephrem Awoke Shiferaw,
  • Tadele Ayelegn Nibret,
  • Gebremariam Maru Yemru,
  • Minyahl Kassye Mengstu,
  • Abebe Birhanu,
  • Afewerk Habtamu,
  • Habtu Debash,
  • Tadelo Wondmagegn,
  • Mulualem Lemma

摘要

Background

Tumor-infiltrating lymphocytes (TILs) are recognized as prognostic biomarkers. However, inconsistent TIL scores across breast cancer stages, and data are scarce for Ethiopian patients. Thus, this study evaluated TIL scores across breast cancer stages in Northwest Ethiopia.

Methods

A cross-sectional study was conducted from 20 June 2024 to 19 June 2025. Using consecutive sampling, 62 breast cancer patients were enrolled, and their socio-demographic and clinicopathological data were collected using questionnaires and chart reviews. Formalin-fixed, paraffin-embedded tissue sections were stained with hematoxylin and eosin, and stromal TILs were evaluated according to the International TIL Working Group guidelines. Data were analyzed using SPSS version 27. Median TILs across clinicopathological variables were assessed using Kruskal-Wallis and Mann-Whitney U tests. Spearman correlation assessed the association of TIL scores and clinicopathological variables. P ≤ 0.05 was considered statistically significant.

Results

Low TIL scores were observed in 76.5% of stage II cases, whereas high TIL scores were observed in 54.5% of stage IV cases. Median TIL percentages in stage IV (48%) and III (33%) were significantly higher than in stage II (7%), and in N2–N3 (33%) than in N0–N1 (9%) (p < 0.001). Moreover, the median TIL percentage in grade III (48%) was higher than in grade I (9%) (p = 0.028). TILs were positively correlated with TNM stage, lymph node stage, and grade.

Conclusions

A positive correlation was found between TIL score and TNM stage. Intermediate and high TIL scores were common in advanced stages, whereas low TIL scores were prevalent in early stages. The findings suggest that advanced tumors may harbor higher mutation burdens and immunogenicity. Future research should explore the molecular subtypes of immune profiles.