肿瘤浸润淋巴细胞是乳腺癌新辅助治疗疗效pCR的预测指标

Tumor-infiltrating Lymphocytes as A Predictive Factor for pCR to Neoadjuvant Treatment in Breast Cancer

目的检测肿瘤浸润淋巴细胞(tumor-infiltrating lymphocytes,TILs)和乳腺癌新辅助治疗疗效病理完全反应(pathological complete response,pCR)的关系及TILs在乳腺癌新辅助治疗前后的动态变化情况。方法收集2014年1月至2018年12月广州医科大学附属肿瘤医院100例乳腺癌新辅助治疗前后配对石蜡标本696块;H&E染色手工评价TILs水平;SPSS 22.0软件分析TILs对pCR的预测作用及TILs在新辅助治疗前后的动态变化。结果二元回归分析模型示总区域TILs(OR 1.182,95%CI 1.030~1.358,P=0.018)和肿瘤区域内TILs(OR 1.727,95%CI 1.137~2.622,P=0.010)具有很好的pCR预测价值。总患者中(100例),新辅助治疗前后TILs在总区域(P<0.0001)、间质区域(P<0.0001)、肿瘤内区域(P=0.057)均显著升高。结论全区域TILs、肿瘤内区域TILs可预测乳腺癌新辅助治疗pCR。新辅助治疗可促进乳腺癌患者肿瘤区域TILs免疫浸润。

Objective This study is to investigate the relationship of tumor-infiltrating lymphocytes and pathological complete response(pCR)to neoadjuvant treatment(NAT)in breast cancer,and to observe the dynamic change of TILs between pre-and post-NAT.Methods A total of 100 cases of breast cancer with 696 paraffin blocks were collected between January 2014 and December 2018 in Affiliated Cancer Hospital&Institute of Guangzhou Medical University.TILs was evaluated by pathologists on H&E sections.SPSS 22.0 was used to detect the predictive value of TILs to pCR and the dynamic change of TILs between pre-and post-NAT.Results Bivariate regression analysis indicated that Total TILs(OR 1.182,95%CI 1.030~1.358,P=0.018)and Intratumoral TILs(OR 1.727,95%CI 1.137~2.622,P=0.010)were statistically significant and independent predictors of pCR.Otherwise,the Total TILs(P<0.0001),Stromal TILs(P<0.0001)and Intratumoral region TILs(P=0.057)in pre-NAT tissue were significantly higher than those in post-NAT.Conclusions Total TILs and Stromal TILs could be predictive factors for pCR to NAT in breast cancer.Meanwhile,NAT could promote Stromal TILs in breast cancer.