三阴性乳腺癌中的 TIL（肿瘤浸润淋巴细胞）：预后意义、预测价值及临床转化的新兴方向

Triple-negative breast cancer (TNBC) represents a biologically aggressive subtype with limited therapeutic targets; however, tumor-infiltrating lymphocytes (TILs) have emerged as the most robust immune biomarker with compelling prognostic and predictive significance. This comprehensive review synthesizes current evidence on TIL assessment methodology; the immunobiological landscape of TNBC, including regulatory T cell populations and PD-L1 correlations; gene expression underpinnings of the tumor immune microenvironment; and systematic evidence from meta-analyses and clinical trials.

Meta-analytic estimates demonstrate that high TIL levels are associated with improved overall survival (HR 0. 58, 95% CI 0. 48-0. 71) and disease-free survival (HR 0. 66, 95% CI 0. 57-0. 76), with each 10% TIL increment conferring incremental benefit. High TILs predict superior pathologic complete response to neoadjuvant chemotherapy (OR 2.

14, 95% CI 1. 43-3. 19), with lymphocyte-predominant breast cancer achieving pCR rates exceeding 80% with pembrolizumab-based chemoimmunotherapy. Future directions include prospective TIL-guided treatment trials, artificial intelligence-enabled standardization, and emerging adoptive TIL cellular therapies for metastatic disease.