外周血Th1型细胞因子与TIL对乳腺癌新辅助化疗效果的预测价值

Predictive Value of TIL and Th1-Type Cytokines in Peripheral Blood on the Efficacy of Neoadjuvant Chemotherapy for Breast Cancer

摘要: 背景：新辅助化疗(NAC)是乳腺癌的重要治疗手段，治疗后达到病理完全缓解(pCR)预示着长期生存的改善。然而，NAC效果因个体差异而异，预测NAC效果对制定治疗方案具有重要意义。患者的免疫系统状态是NAC成功的关键，Th1型细胞因子和TIL与抗肿瘤免疫反应密切相关，可能影响NAC的效果。目的：本研究旨在探讨新辅助化疗前外周血Th1型细胞因子与TIL对乳腺癌新辅助化疗效果的预测价值。方法：收集乳腺癌患者化疗前的血清样本，检测外周血Th1型细胞因子水平，并对肿瘤间质组织进行TIL水平评估。通过统计分析，评估Th1型细胞因子和TIL与NAC疗效的关系。结果：根据手术后的病理结果将患者分为pCR组和非pCR组。在治疗前，外周血高水平Th1型细胞因子的患者在接受NAC后表现出更高的病理缓解率。治疗后达到pCR的患者中，TIL的增加与外周血Th1型细胞因子的升高呈正相关。结论：在新辅助化疗开始前，外周血Th1型细胞因子可作为预测NAC效果的生物标志物，Th1型细胞因子水平还可以作为高TIL的代替标志物，与TIL一起更好地预测新辅助化疗的疗效。

Abstract: Background: Neoadjuvant chemotherapy (NAC) is an important treatment for breast cancer, and achieving pathologic complete response (pCR) after treatment indicates improved long-term survival. However, the effect of NAC varies from individual to individual, and predicting the effect of NAC is of great significance in formulating treatment plans. The immune system status of patients is the key to the result of NAC. Th1-type cytokines and TIL are closely related to anti-tumor immune response, which may affect the effect of NAC. Objective: The purpose of this study was to investigate the predictive value of TIL and Th1-type cytokines in peripheral blood before neoadjuvant chemotherapy on the effect of neoadjuvant chemotherapy in breast cancer. Method: Serum samples from breast cancer patients before chemotherapy were collected to detect the levels of Th1-type cytokines in peripheral blood, and TIL levels in tumor stromal tissue were evaluated. Through statistical analysis, the relationship between Th1-type cytokines, TIL, and the efficacy of NAC was assessed. Result: Based on the pathological results after surgery, patients were divided into pCR group and non-pCR group. Before treatment, patients with high levels of Th1-type cytokines in peripheral blood showed a higher pCR rate after receiving NAC. Among patients who achieved pCR after treatment, the increase in TIL was positively correlated with the elevation of Th1-type cytokines in peripheral blood. Conclusion: Before the neoadjuvant chemotherapy, Th1-type cytokines in peripheral blood can serve as biomarkers for predicting the efficacy of NAC. The level of Th1-type cytokines can also be used as surrogate biomarkers for high TIL, together with TIL to better predict the efficacy of neoadjuvant chemotherapy.