Association of tumor-infiltrating lymphocytes before and after neoadjuvant chemotherapy with pathological complete response and prognosis in patients with breast cancer.
Association of tumor-infiltrating lymphocytes before and after neoadjuvant chemotherapy with pathological complete response and prognosis in patients with breast cancer.
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新辅助化疗之前和之后的肿瘤浸润淋巴细胞与乳腺癌患者的病理完全反应和预后的关联。
DOI：
10.1002/cam4.4302
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发表时间：
2021-11
期刊：
影响因子：
4
通讯作者：
Shen K
中科院分区：
文献类型：
--
作者：
Hong J;Rui W;Fei X;Chen X;Shen K
探讨乳腺癌患者新辅助化疗（NAC）前后肿瘤浸润淋巴细胞（TILs）的预测和预后价值。回顾性分析2008年8月至2019年11月连续接受NAC治疗的乳腺癌患者。评估侵袭性肿瘤样本的TIL水平，以TIL水平在10%至10%之间为高表达。病理完全缓解（pCR）定义为乳腺或淋巴结无浸润性肿瘤。采用单因素和多因素分析评估与pCR率、无病生存期（DFS）和总生存期相关的因素。共纳入461例患者。pCR患者的平均NAC前TIL水平高于未pCR患者（分别为24.28%±2.34% vs. 11.34%±0.60%,p < 0.0001）。多因素分析显示，NAC前较高的TIL水平是较高pCR的独立危险因素（优势比= 3.92,95% CI = 2.23-6.90, p < 0.001）。NAC前TIL水平高的患者比NAC前TIL水平低的患者有更好的5年DFS（84.5%比68.9%,HR = 0.50, 95% CI = 0.31-0.81, p = 0.005）。多因素分析显示，NAC前TIL （HR = 0.48; 95% CI = 0.29-0.81, p = 0.006）与无pCR患者的DFS显著相关，但NAC后TIL （HR = 0.89, 95% CI = 0.50-1.59, p = 0.699）与无pCR患者的DFS显著相关。此外，NAC前和NAC后TIL水平低的患者的5年DFS比NAC前TIL水平高的患者差（HR = 2.09, 95% CI = 1.23-3.56, p = 0.007）。NAC前TIL水平可以预测接受NAC的乳腺癌患者的pCR和DFS。对于没有pCR的患者，NAC前TIL和TIL类别变化与DFS显著相关，但NAC后TIL没有变化。
To evaluate the predictive and prognostic value of tumor‐infiltrating lymphocytes (TILs) before and after neoadjuvant chemotherapy (NAC) in patients with breast cancer. Consecutive breast cancer patients treated with NAC between August 2008 and November 2019 were retrospectively analyzed. TIL levels were evaluated of invasive tumor samples, and high expression was defined as TILs >10%. Total pathological complete response (pCR) was defined as no invasive tumor in the breast or lymph nodes. Univariate and multivariate analyses were used to assess factors associated with pCR rate, disease‐free survival (DFS), and overall survival. A total of 461 patients were included. The mean pre‐NAC TIL level was higher among patients with pCR than among patients without pCR (24.28% ± 2.34% vs. 11.34% ± 0.60%, respectively, p < 0.0001). The multivariate analysis demonstrated that a high pre‐NAC TIL level was an independent risk factor for a higher pCR (odds ratio = 3.92, 95% CI = 2.23–6.90, p < 0.001). Patients with high pre‐NAC TIL levels had a better 5‐year DFS than those with low pre‐NAC TIL levels (84.5% vs. 68.9%, HR = 0.50, 95% CI = 0.31–0.81, p = 0.005). The multivariate analysis showed that pre‐NAC TIL (HR = 0.48; 95% CI = 0.29–0.81, p = 0.006) but not post‐NAC TIL (HR = 0.89, 95% CI = 0.50–1.59, p = 0.699) was significantly associated with DFS among patients without pCR. Furthermore, patients with low pre‐ and post‐NAC TIL levels had a worse 5‐year DFS than those with high pre‐NAC TIL levels (HR = 2.09, 95% CI = 1.23–3.56, p = 0.007). Pre‐NAC TIL level can predict pCR and DFS in patients with breast cancer receiving NAC. For patients without pCR, pre‐NAC TIL, and TIL category change, but not post‐NAC TIL, were significantly associated with DFS.
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10.1007/s00432-019-03083-y
发表时间：
2020-02-01
影响因子：
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作者：
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影响因子：
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10.1016/s1470-2045(16)30631-3
发表时间：
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The Lancet. Oncology
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