TIL（肿瘤浸润淋巴细胞）在三阴性乳腺癌中的预测与预后价值：一项来自越南的真实世界研究

The clinical validity of tumor-infiltrating lymphocytes (TILs) has been investigated extensively in triple-negative breast cancer (TNBC). However, inconsistent cutoff values across studies limit its clinical application.

To determine the optimal TILs cutoff predicting pathological complete response (pCR) and event-free survival (EFS) in Vietnamese TNBC patients undergoing neoadjuvant chemotherapy (NACT). DESIGN: A single-center, retrospective cohort study of 106 stage II-III TNBC patients treated with NACT at Ho Chi Minh City Oncology Hospital between January 2022 and May 2023.

Stromal TILs (sTILs) were evaluated on pre-treatment biopsy specimens using the International TILs Working Group guideline. The optimal cutoff was determined using receiver operating characteristic curve analysis. Logistic regression and Cox proportional hazards models were used to analyze potentially predictive and prognostic factors.

An optimal 20% TILs cutoff stratified the cohort into high- and low-TIL groups, with significantly different pCR rates (50.9% vs 9.8%, p < 0.001). High TILs (odds ratio (OR) = 8.22, p < 0.001) and lower clinical tumor status (OR = 3.64, p = 0.033) independently predicted pCR. TILs (hazard ratio (HR) = 0.38, p = 0.017) and pCR status (HR = 0.08, p = 0.017) were independent prognostic factors for EFS.

A sTIL cutoff of 20% effectively predicts chemotherapy response and survival outcome in Vietnamese TNBC patients, supporting its use in clinical decision-making.