CD8+T淋巴细胞浸润与三阴性乳腺癌新辅助化疗疗效的关系

Relation Between CD8+T Lymphocyte Infiltration and Efficacy of Neoadjuvant Chemotherapy for Triple-negative Breast Cancer

目的探讨三阴性乳腺癌组织CD8+T淋巴细胞浸润(CD8+Tils)的特点与患者预后的关系。方法回顾性分析术前行新辅助化疗的126例三阴性乳腺癌患者的临床病理资料,采用免疫组织化学法分析CD8+Tils与临床病理特征的关系;Kaplan-Meier法绘制生存曲线,Cox风险比例回归模型分析患者无病生存时间(DFS)的预后影响因素。结果高密度CD8+Tils浸润与年龄<60岁、病理高分级、临床高分期显著相关(P<0.05)。CD8+Tils高密度浸润患者术后pCR率较低密度组高(66.7%vs.19.8%,P=0.000)。高密度组中位DFS显著长于CD8+Tils低密度组(49 vs.25月,P<0.05)。多因素分析显示病理高分级、肿瘤直径>2 cm、淋巴结转移、脉管侵犯、CD8+Tils低密度浸润均为预后不良影响因素(P<0.05),CD8+Tils为独立预后因素。结论CD8+Tils有可能是三阴性乳腺癌患者独立预后指标,高密度浸润患者术后pCR率高、DFS长、远期疗效更优。

Objective To investigate the relation between the characteristics of CD8+T lymphocyte infiltration and the prognosis of triple-negative breast cancer patients.Methods We retrospectively analyzed the clinicopathological data of 126 patients with triple-negative breast cancer undergoing preoperative neoadjuvant chemotherapy.Immunohistochemical staining was used to analyze the relation between CD8+T lymphocyte infiltration and clinicopathological characteristics.Kaplan-Meier method was used to draw the survival curve,and Cox risk ratio regression model was used to analyze the prognostic factors affecting disease-free survival time(DFS).Results High-density CD8+Tils was associated with age<60 years old,high pathological grade and high clinical stage(P<0.05).The pCR rate of high-density CD8+Tils group was higher than that of the low-density group(66.7%vs.19.8%,P=0.000).The median DFS of the high-density group was significantly longer than that of the low-density group(49 vs.25 months,P<0.05).Multivariate analysis showed that high pathological grade,tumor diameter>2 cm,lymph node metastasis,vascular invasion and CD8+Tils low-density infiltration were factors for poor prognosis(P<0.05),and CD8+Tils was an independent prognostic factor.Conclusion CD8+Tils may be an independent prognostic indicator for triple-negative breast cancer.The patients with high-density infiltration have high postoperative pCR rate,long DFS and better long-term efficacy.