本研究旨在评估各种免疫调节细胞和试验在三阴性乳腺癌（TNBC）中的表达状态和预后作用。通过免疫组织化学方法回顾性地评估了68个TNBC连续病例的肿瘤部位中五个标记物（CD3/CD4/CD8/CD19/CD163）的肿瘤免疫细胞表达。使用计算机图像分析定量测量了肿瘤区域、肿瘤浸润边缘和表达热点中每个免疫标记的密度和分布。采用自动化方法计算了免疫评分。同时也分析了其他临床特征。对于所有患者，Kaplan-Meier生存分析显示，肿瘤区域（无病生存（DFS），P=0.0014；总生存（OS），P=0.0031）和总区域（DFS，P=0.0014；OS，P=0.0031）中高的CD3+信号与更好的生存显著相关。肿瘤区域和总区域中高水平的CD4+与更好的生存显著相关（P<0.05）。对于点热点分析，所有Top1、Top2和Top3密度的CD3+与更好的生存显著相关（DFS和OS，P<0.05）。高水平的CD4+与Top1和Top3密度的更好预后显示显著相关（DFS和OS，P<0.05）。对于IIB和IIIC期患者，发现肿瘤区域和所有Top热点中的CD3+与生存显著相关（DFS和OS，P<0.05）。CD4+细胞与肿瘤区域、总区域和Top3密度中的生存显著相关（DFS，P=0.0213；OS，P=0.0728）。CD8+细胞与浸润边缘、Top2密度和Top3密度的生存显著相关。空间参数分析显示，肿瘤细胞和免疫细胞（CD3+、CD4+或CD8+）的高共定位显著与患者生存相关。计算机图像分析是评估TNBC免疫调节细胞密度和分布的可靠工具，也可以计算免疫评分。免疫评分保留了在IIB期之后TNBC的预后意义。未来的研究需要确认其预测肿瘤对化疗和免疫治疗的反应的潜力。版权所有 © 2023 Ren，Song，Pang，Chen，Zhou，Liang和Wu。

This study aimed to evaluate the expression status and prognostic role of various immunoregulatory cells and test in triple-negative breast cancer (TNBC).The expression of five markers (CD3/CD4/CD8/CD19/CD163) of tumor immune cells was evaluated retrospectively in tumor sections from 68 consecutive cases of TNBC by immunohistochemistry. Computational image analysis was used to quantify the density and distribution of each immune marker within the tumor region, tumor invasive margin, and expression hotspots. Immunoscores were calculated using an automated approach. Other clinical characteristics were also analyzed.For all patients, Kaplan-Meier survival analysis showed that high CD3+ signals in the tumor region (disease-free survival (DFS), P=0.0014; overall survival (OS), P=0.0031) and total region (DFS, P=0.0014; OS, P=0.0031) were significantly associated with better survival. High CD4+ levels in the tumor region and total regions were significantly associated with better survival (P<0.05). For Hotspot analysis, CD3+ was associated with significantly better survival for all Top1, Top2, and Top3 densities (DFS and OS, P<0.05). High CD4+ levels were significantly associated with better prognosis for Top1 and Top3 densities (DFS and OS, P<0.05). For stage IIB and IIIC patients, CD3+ in the tumor region and all Top hotspots was found to be significantly correlated with survival (DFS and OS, P<0.05). CD4+ cells were significantly associated with survival in the tumor region, total region, and Top3 density (DFS, P=0.0213; OS, P=0.0728). CD8+ cells were significantly associated with survival in the invasive margin, Top2 density, and Top3 density. Spatial parameter analysis showed that high colocalization of tumor cells and immune cells (CD3+, CD4+, or CD8+) was significantly associated with patient survival.Computational image analysis is a reliable tool for evaluating the density and distribution of immune regulatory cells and for calculating the Immunoscore in TNBC. The Immunoscore retains its prognostic significance in TNBC later than IIB stage breast cancer. Future studies are required to confirm its potential to predict tumor responses to chemotherapy and immune therapy.Copyright © 2023 Ren, Song, Pang, Chen, Zhou, Liang and Wu.