肿瘤浸润性淋巴细胞比例在乳腺癌新辅助化疗中的意义

Tumor-infiltrating Lymphocytes Predict Response to Neoadjuvant Chemotherapy in Patients with Breast Carcinoma

目的探讨肿瘤浸润性淋巴细胞比例与乳腺癌新辅助化疗疗效的关系。方法收集南京医科大学第一附属医院2010年12月—2013年11月期间接受新辅助化疗后可确认手术切除的59例女性乳腺癌患者资料,采用肿瘤浸润淋巴细胞计数评分检测化疗前每个患者的肿瘤内与间质内淋巴细胞计数总得分及术后间质内淋巴细胞计数得分,并采用Miller和Payne(MP)治疗反应评价方法评价术后乳腺癌组织的病理治疗反应,统计分析两者间的关系。结果浸润淋巴细胞高比例组(3~6级)的新辅助化疗有效率明显高于低比例组(0~2级),差异具有统计学意义(P=0.001),化疗后间质淋巴细胞比例提高组化疗有效率高于比例无变化组,差异具有统计学意义(P=0.031)。结论肿瘤浸润淋巴细胞和化疗反应之间存在较强的相关性,肿瘤浸润性淋巴细胞可望成为预测新辅助化疗疗效的一个重要参数。

Objective To investigate the association between tumor-infiltrating lymphocytes and neoadjuvant chemotherapeutic effect in patients with breast carcinoma. Methods We retrospectively evaluated 59 female patients with breast carcinoma treated with neoadjuvant chemotherapy followed by definitive surgical resection in the First Affiliated Hospital of Nanjing Medical University from December, 2010 to November, 2013. By the method of tumor-infiltrating lymphocyte count score, we counted the total score of intratumoral lymphocytes and stromal lymphocytes before chemotherapy, as well as the stromal lymphocytes after the operation. The pathological responses were evaluated by Miller and Payne(MP) grading system criteria after the operation. Then the correlation between tumor-infiltrating lymphocytes and the pathological responses after the operation were investigated. Results The remission rate of neoadjuvant chemotherapy in the highpercentage tumor-infiltrating lymphocytes group(3-6 level) was more effective than that in the low-percentage group(0-2 level)(P=0.001). The higher stromal lymphocytes percentage after the neoadjuvant chemotherapy had the higher remission rate(P=0.031). Conclusion Tumor-infiltrating lymphocytes have strong correlation with pathological responses to chemotherapy and they would be the important parameters in predicting the remission rate of neoadjuvant chemotherapy.