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TIL(肿瘤浸润淋巴细胞)对浸润性乳腺癌患者新辅助化疗无缓解率的影响

英文原题:Effects of tumor-infiltrating lymphocytes on nonresponse rate of neoadjuvant chemotherapy in patients with invasive breast cancer.

查看英文原题

Effects of tumor-infiltrating lymphocytes on nonresponse rate of neoadjuvant chemotherapy in patients with invasive breast cancer.

PubMed 2023/06/07(内容时间) Sci Rep Q1 · IF 4.9(JCR 2025)

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中文摘要

高水平的TIL(肿瘤浸润淋巴细胞)(TILs)可以预测接受新辅助化疗(NACT)的乳腺癌患者的总病理完全缓解(tpCR)率。

本研究聚焦于评估原发肿瘤和/或淋巴结转移对NACT表现为无反应(NR)的患者数据,试图为临床判断哪些患者将出现NACT耐药提供依据。

该研究纳入了991例接受NACT的乳腺癌患者。ROC曲线分析证实,TILs对激素受体(HR)+HER2-和三阴性乳腺癌(TNBC)的NR具有显著预测价值。在HR+HER2-乳腺癌中,TILs ≥ 10%是低NR率的独立预测因素。

此外,TILs与Ki67指数和Miller-Payne分级呈正相关,与ER和PR H评分呈负相关,这些相关性仅在该亚组中被发现。在TNBC中,TILs ≥ 17.5%是低NR率的独立预测因素。低TILs对NR的预测价值可能有助于筛选出可能无法从NACT中获益的HR+HER2-或TNBC患者。对于TILs水平低的HR+HER2-乳腺癌,应谨慎进行新辅助化疗,并可考虑其他替代方案,如新辅助内分泌治疗。

展开英文摘要原文

High level of tumor-infiltrating lymphocytes (TILs) can predict the rate of total pathological complete remission (tpCR) of breast cancer patients who receive neoadjuvant chemotherapy (NACT).

This study focused on evaluating the data of patients whose primary tumor and/or lymph node metastasis show nonresponse (NR) to NACT, trying to provide a basis for the clinical decision which patients will develop NACT resistance. The study included breast cancers from 991 patients who received NACT. ROC curve analysis confirmed that TILs showed significant predictive value for NR of hormone receptor (HR)+HER2- and triple-negative breast cancer (TNBC). Among HR+HER2- breast cancer, TILs ≥ 10% was an independent predictor for low NR rate.

Furthermore, positive correlation of TILs with Ki67 index and Miller-Payne grade, and negative correlation with ER and PR H-scores were only identified in this subgroup. In TNBC, TILs ≥ 17. 5% was an independent predictor for low NR rate. The predictive value of low TILs on NR may facilitate to screen patients with HR+HER2- or TNBC who may not benefit from NACT. HR+HER2- breast cancer with low levels of TILs should be carefully treated with neoadjuvant chemotherapy, and other alternatives such as neoadjuvant endocrine therapy can be considered.

论文信息

作者
Qian XL、Xia XQ、Li YQ、Jia YM、Sun YY、Song YM、Xue HQ、Hao YF
第一作者单位
Department of Breast Pathology and Lab, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, National Human Genetic Resource Sharing Service Platform, West Huanhu Road, Tianjin, 300060, China.China
通讯作者单位
Department of Breast Pathology and Lab, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, National Human Genetic Resource Sharing Service Platform, West Huanhu Road, Tianjin, 300060, China. guoxiaojing@tjmuch.com.China
文献类型
非美国政府资助研究
期刊
Scientific reports2023 Jun 7
原文标识
PubMed 37286786 · DOI 10.1038/s41598-023-36517-2