肿瘤间质浸润淋巴细胞与乳腺癌新辅助化疗效果的相关性

The Correlation between Tumor Interstitial Infiltrating Lymphocytes and the Effect of Neoadjuvant Chemotherapy in Breast Cancer

摘要: 目的：评估乳腺癌穿刺标本中肿瘤间质浸润淋巴细胞(stromal tumor-infiltrating lymphocytes, sTILs)与新辅助化疗效果的相关性。方法：收集126例乳腺癌穿刺标本及其新辅助化疗后手术切除标本，评估穿刺标本中HE切片肿瘤区域内sTILs的比例与新辅助化疗后手术标本治疗效果的相关性，并复习相关文献。结果：乳腺癌治疗前穿刺标本中sTILs高水平表达与新辅助化疗病理完全缓解(pathologiccomplete response, pCR)呈正相关，sTILs的浸润密度与ER状态、PR状态及分子亚型差异有统计学意义。结论：乳腺癌治疗前穿刺标本中肿瘤浸润淋巴细胞中sTILs比例可作为新辅助化疗有效性的预测指标，提示高水平sTILs的患者更容易获得pCR，特别是在三阴或Her-2阳性的乳腺癌患者，对患者的个体化精准治疗方案的选择提供更多的因素。

Abstract: Purpose: To evaluate the correlation between stromal tumor-infiltrating lymphocytes (sTILs) in breast cancer puncture specimens and the efficacy of neoadjuvant chemotherapy. Methods: 126 cases of breast cancer biopsy specimens and surgical resection specimens after neoadjuvant chem-otherapy were collected. The correlation between the proportion of sTILs in the tumor area of HE section in the biopsy specimens and the therapeutic effect of surgical specimens after neoadjuvant chemotherapy was evaluated, and the relevant literature was reviewed. Results: The high expres-sion of sTILs in the biopsy specimens of breast cancer before treatment was positively correlated with the pathologic complete response (pCR) of neoadjuvant chemotherapy. The infiltration density of sTILs was significantly different from ER status, PR status and molecular subtypes. Conclusion: The proportion of sTILs in tumor infiltrating lymphocytes in pre-treatment puncture specimens of breast cancer can be used as a predictor of the effectiveness of neoadjuvant chemotherapy, sug-gesting that patients with high levels of sTILs are more likely to obtain pCR, especially in tri-ple-negative or Her-2-positive breast cancer patients, providing more factors for the choice of indi-vidualized precise treatment options for patients.