基于 DNA 超分子水凝胶的保护性 NK 细胞储库用于增强三阴性乳腺癌治疗
Protective NK Cell Reservoir Based on DNA Supramolecular Hydrogel for Enhanced Triple-Negative Breast Cancer Therapy.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
未接受（新）辅助系统治疗的年轻、淋巴结阴性、三阴性乳腺癌患者中基质 TIL（肿瘤浸润淋巴细胞）的预后价值
英文原题：Prognostic Value of Stromal Tumor-Infiltrating Lymphocytes in Young, Node-Negative, Triple-Negative Breast Cancer Patients Who Did Not Receive (neo)Adjuvant Systemic Therapy.
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Prognostic Value of Stromal Tumor-Infiltrating Lymphocytes in Young, Node-Negative, Triple-Negative Breast Cancer Patients Who Did Not Receive (neo)Adjuvant Systemic Therapy.
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研究概要
未经化疗的年轻 N0 TNBC 患者，若 sTILs 高（≥ 75%），长期预后极佳。因此，在探讨（新）辅助化疗降阶梯策略的前瞻性临床试验中，应考虑 sTILs。
研究思路结论见上方概要
目的
三阴性乳腺癌（TNBC）被认为具有侵袭性，因此几乎所有年轻TNBC患者都会接受（新）辅助化疗。间质TIL（肿瘤浸润淋巴细胞）（sTILs）增加与TNBC良好预后相关。然而，这种相关性是否适用于淋巴结阴性（N0）、年轻（< 40岁）且未接受过化疗的患者，从而可用于化疗降阶梯策略，目前尚不清楚。
方法
我们选取了1989年至2000年间在荷兰基于人群的登记中诊断为N0 TNBC的所有患者。患者诊断时年龄<40岁，且未接受（新）辅助全身治疗，这是当时的标准做法。检索了福尔马林固定石蜡包埋块（PALGA：荷兰病理学登记），并进行了包括sTILs在内的病理学审查。根据sTILs将患者分类（<30%、30%-75%和≥75%）。对总生存期进行了多变量Cox回归，以sTILs作为协变量或不作为协变量。在竞争风险模型中分析了远处转移或死亡的累积发生率，以第二原发肿瘤作为竞争风险。
结果
对441例患者进行了sTILs评分。高sTILs（≥ 75%；21%）预示着极好的预后，15年远处转移或死亡的累积发生率仅为2.1%（95% CI，0至5.0），而低sTILs（< 30%；52%）预后不良，15年远处转移或死亡的累积发生率为38.4%（32.1至44.6）。此外，sTILs每增加10%，死亡风险降低19%（调整风险比：0.81；95% CI，0.76至0.87），这是一个独立的预测因子，在标准临床病理变量之外增加了预后信息（χ 2 = 46.7，P < .001）。
展开英文摘要原文
PURPOSE
Triple-negative breast cancer (TNBC) is considered aggressive, and therefore, virtually all young patients with TNBC receive (neo)adjuvant chemotherapy. Increased stromal tumor-infiltrating lymphocytes (sTILs) have been associated with a favorable prognosis in TNBC. However, whether this association holds for patients who are node-negative (N0), young (< 40 years), and chemotherapy-naïve, and thus can be used for chemotherapy de-escalation strategies, is unknown.
METHODS
We selected all patients with N0 TNBC diagnosed between 1989 and 2000 from a Dutch population-based registry. Patients were age < 40 years at diagnosis and had not received (neo)adjuvant systemic therapy, as was standard practice at the time. Formalin-fixed paraffin-embedded blocks were retrieved (PALGA: Dutch Pathology Registry), and a pathology review including sTILs was performed. Patients were categorized according to sTILs (< 30%, 30%-75%, and ≥ 75%). Multivariable Cox regression was performed for overall survival, with or without sTILs as a covariate. Cumulative incidence of distant metastasis or death was analyzed in a competing risk model, with second primary tumors as competing risk.
RESULTS
sTILs were scored for 441 patients. High sTILs (≥ 75%; 21%) translated into an excellent prognosis with a 15-year cumulative incidence of a distant metastasis or death of only 2.1% (95% CI, 0 to 5.0), whereas low sTILs (< 30%; 52%) had an unfavorable prognosis with a 15-year cumulative incidence of a distant metastasis or death of 38.4% (32.1 to 44.6). In addition, every 10% increment of sTILs decreased the risk of death by 19% (adjusted hazard ratio: 0.81; 95% CI, 0.76 to 0.87), which are an independent predictor adding prognostic information to standard clinicopathologic variables (χ 2 = 46.7, P < .001).
CONCLUSION
Chemotherapy-naïve, young patients with N0 TNBC with high sTILs (≥ 75%) have an excellent long-term prognosis. Therefore, sTILs should be considered for prospective clinical trials investigating (neo)adjuvant chemotherapy de-escalation strategies.
论文信息
- 作者
- de Jong VMT、Wang Y、Ter Hoeve ND、Opdam M、Stathonikos N、Jóźwiak K、Hauptmann M、Cornelissen S
- 单位
- Department of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.Netherlands
- 文献类型
- 非美国政府资助研究
- 期刊
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology2022 Jul 20
- 原文标识
- PubMed 35353548 · DOI 10.1200/JCO.21.01536
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