Tumor-Infiltrating Lymphocytes (TILs) and Risk of a Second Breast Event After a Ductal Carcinomain situ
Tumor-Infiltrating Lymphocytes (TILs) and Risk of a Second Breast Event After a Ductal Carcinomain situ
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DOI：
10.3389/fonc.2020.01486
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发表时间：
2020-08-19
影响因子：
4.7
通讯作者：
Rocca, Andrea
中科院分区：
文献类型：
--
作者：
Farolfi, Alberto;Petracci, Elisabetta;Rocca, Andrea
被诊断为导管原位癌(DCIS)的女性发生第二次乳房事件(SBE)的风险很高。免疫系统可能在试图预防SBE方面发挥作用。1997年至2010年，Vasta Romagna地区以人口为基础的癌症登记中确认了被诊断为DCIS的患者。中位随访期为8.5年。肿瘤浸润性淋巴细胞(TIL)在DCIS指数和SBE指数中进行评估。主要终点是评估DCIS指数中TILs水平与SBE风险之间的关系。在496例DCIS患者中，100例(20.2%)发现SBE：同侧55例(11.1%)，对侧43例(8.7%)。TIL的分布是不均匀的，但与分级、坏死、筛查和手术类型显著相关。按TILs百分比(5%)分层的患者SBEs的5年累积发生率分别为14.9%(95%CI11.3~19.1)和11.0%(95%CI6.9~16.2)，差异无统计学意义(p=0.147)。在未接受放射治疗的患者亚组中，TILs和Gt；5%与SBE风险降低相关(HR0.34，95%CI0.14-0.82，p=0.016)。虽然我们没有发现TILs和SBE之间有任何显著的关联，但根据放射治疗评估它们的作用的进一步研究是有必要的。
Women with a diagnosis of ductal carcinomain situ(DCIS) have a high risk of developing a second breast event (SBE). The immune system might play a role in trying to prevent a SBE. Patients diagnosed with DCIS were identified in the population-based cancer registry of Area Vasta Romagna from 1997 to 2010. Median follow-up is 8.5 years. Tumor-infiltrating lymphocytes (TILs) were evaluated both in index DCIS and in SBE. The main endpoint was to assess the association between TILs' levels in index DCIS and risk of a SBE. Out of 496 DCIS patients, 100 SBEs (20.2%) were identified: 55 ipsilateral (11.1%) and 43 contralateral (8.7%). The distribution of TILs was heterogeneous, but significantly associated with grade, necrosis, screen detection and type of surgery. Patients stratified according to TILs percentage (5%) did not show a statistically significant difference in the 5-year cumulative incidence of SBEs: 14.9% (95% CI 11.3-19.1) and 11.0% (95% CI, 6.9-16.2), respectively (p= 0.147). In the subgroup of patients who did not receive radiotherapy, TILs >5% were associated with a reduced risk of SBE (HR 0.34, 95% CI 0.14-0.82,p= 0.016). Although we did not find any significant association between TILs and SBE, further studies evaluating their role according to radiotherapy are warranted.