基于免疫基因图谱与 IHC 的 CTL-NK 特征预测三阴性乳腺癌临床结局

We combined NanoString immune gene profiling with whole-slide immunohistochemistry (IHC) in a TNBC cohort ( n = 155). Quantitative and spatial analyses were performed to assess CTL and NK cell infiltration and their associations with clinicopathological features and survival outcomes.

High TIL density ( 10%) and elevated CTL-NK scores ( 2) correlated with lower tumor stage, absence of lymphovascular invasion (LVI), and favorable immune subset ratios (all p < 0.05). In multivariable analysis, absence of LVI, high CD4 + and CD8 + infiltration, and CTL-NK score 2 independently predicted improved disease-free survival (DFS; hazard ratio [HR] range 0.45-0.62, all p < 0.05). CD4 + infiltration demonstrated the strongest prognostic effect, while CD8 + infiltration and the CTL-NK score also conferred independent benefit.

Quantitative and spatial assessment of CTL and NK infiltration provides independent prognostic information in TNBC. The CTL-NK score can be integrated into routine pathology and may refine risk stratification, supporting personalized immunotherapy strategies. Triple-negative breast cancer (TNBC) is an aggressive form of breast cancer that lacks targeted treatments and often has poorer outcomes compared with other subtypes. Immune cells within the tumor, called tumor-infiltrating lymphocytes (TILs), can influence how the cancer behaves and how patients respond to treatment. In this study, we looked closely at two types of immune cells cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells and the proteins they use to destroy cancer cells, granulysin (GNLY) and granzyme B (GZMB). Using both immune gene testing and special staining of tumor samples, we measured how many of these cells were present and where they were located in the tumor. We found that patients whose tumors had higher CTL and NK cell activity lived longer without the cancer returning. We created a simple CTL NK score that could help doctors predict outcomes in TNBC and identify patients who may benefit most from immunotherapy.