Eryilmaz Melek Karakurt, Mutlu Hasan, Ünal Betül, Salim Derya Kıvrak, Musri Fatma Yalçın, Coşkun Hasan Şenol
Department of Medical Oncology, School of Medicine, Akdeniz University, Konyaalti, Antalya 07070, Turkey.
Department of Pathology, School of Medicine, Akdeniz University, Konyaalti, Antalya 07070, Turkey.
J Cancer Res Ther. 2018 Apr-Jun;14(3):619-624. doi: 10.4103/0973-1482.174550.
Increased tumor-infiltrating lymphocytes (TILs) in breast carcinoma tissues is an independent predictive factor for pathologic complete response (pCR). The increased intratumoral and stromal TILs (sTILs) in breast cancer (BC) have significant prognostic effects. In this study, we evaluated whether pCR rates to neoadjuvant chemotherapy (NACT) are higher in tumors with increased number of TILs in the pretreatment biopsy.
We retrospectively evaluated the number of TILs in intratumoral TILs (iTILs) and sTILs compartments from pretreatment full-face hematoxylin and eosin-stained sections of 62 patients with locally advanced BC (LABC) who received NACT. The capacity of sTILs and iTILs in predicting pCR to NACT in LABC analyzed using receiver operating characteristic (ROC) curve analysis.
According to ROC curve analysis, the optimum sTILs and iTILs cut-off points (the number of positive cells per square millimeter of tissue) for patients with LABC patients with pCR (+) were 19 (area under the curve (AUC): 0.668, 95% confidence interval [CI] [0.501-0.835],P = 0.064) and 4 (AUC: 0.786, 95%CI [0.666-0.907],P = 0.002), respectively. Of the 62 patients, 26 had sTILs >19 and 25 had iTILs >4. The patients were divided into two according to percent of sTILs (sTILs >19 and sTILs ≤19 groups) and iTILs (iTILs >4 and iTILs ≤4 groups). Both sTILs >19 and iTILs >4 patients were associated with development higher pCR. While pCR was significantly higher in iTILs >4 patients (P = 0.002), it was not significantly in sTILs >19 patients (P = 0.107).
There is significantly an association between pCR and increased number of intratumoral TILs (>4 cells/mm of tissue) in BC who received NACT.
乳腺癌组织中肿瘤浸润淋巴细胞（TILs）增加是病理完全缓解（pCR）的独立预测因素。乳腺癌（BC）中肿瘤内和基质TILs（sTILs）增加具有显著的预后影响。在本研究中，我们评估了在预处理活检中TILs数量增加的肿瘤对新辅助化疗（NACT）的pCR率是否更高。
我们回顾性评估了62例接受NACT的局部晚期BC（LABC）患者预处理全脸苏木精和伊红染色切片中肿瘤内TILs（iTILs）和sTILs区域的TILs数量。使用受试者工作特征（ROC）曲线分析来分析sTILs和iTILs预测LABC患者对NACT的pCR的能力。
根据ROC曲线分析，LABC患者pCR（+）患者的最佳sTILs和iTILs截断点（每平方毫米组织中的阳性细胞数）分别为19（曲线下面积（AUC）：0.668，95%置信区间[CI][0.501 - 0.835]，P = 0.064）和4（AUC：0.786，95%CI[0.666 - 0.907]，P = 0.002）。62例患者中，26例sTILs>19，25例iTILs>4。根据sTILs百分比（sTILs>19组和sTILs≤19组）和iTILs（iTILs>4组和iTILs≤4组）将患者分为两组。sTILs>19和iTILs>4的患者均与更高的pCR发生率相关。虽然iTILs>4的患者pCR显著更高（P = 0.002），但sTILs>19的患者pCR无显著差异（P = 0.107）。
在接受NACT的BC患者中，pCR与肿瘤内TILs数量增加（>4个细胞/mm²组织）之间存在显著关联。
