Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
J Transl Med. 2019 Jan 7;17(1):13. doi: 10.1186/s12967-019-1773-y.
The immune tumor microenvironment (iTME) is thought to affect the response to chemotherapy, and tumor-infiltrating lymphocytes (TILs) are often used as an indicator to evaluate the iTME. Smoking is involved in carcinogenesis, the relationship between smoking and the iTME of lung cancer has been reported. We hypothesized that smoking would affect the iTME of breast cancer and aimed to examine this relationship based on the amount of pre-diagnosis smoking and the subsequent effects on treatment response and prognosis.
This retrospective study evaluated data from 149 patients who underwent preoperative chemotherapy for triple-negative or HER2-enriched breast cancer. TILs were assessed in biopsy specimens at diagnosis. The data of all patients were used to calculate each patient's smoking amount based on pack-years.
Relative to the low smoking group, the high smoking group had a significant greater TILs density (p = 0.043) and a significantly better pathological complete response (pCR) rate (p = 0.042). However, there was no significant difference according to smoking amount in disease-free survival (p = 0.114) or overall survival (p = 0.347).
Smoking may influence the iTME, with an activated iTME being associated with pCR rate. Therefore, controlled activation of the microenvironment in this setting may help improve patients' prognosis.
免疫肿瘤微环境（iTME）被认为会影响化疗的反应，肿瘤浸润淋巴细胞（TILs）常被用作评估 iTME 的指标。吸烟与癌症的发生有关，已经有报道称吸烟与肺癌的 iTME 之间存在关系。我们假设吸烟会影响乳腺癌的 iTME，并旨在根据诊断前吸烟量以及随后对治疗反应和预后的影响来检验这种关系。
这项回顾性研究评估了 149 名接受三阴性或 HER2 富集型乳腺癌术前化疗的患者的数据。在诊断时对活检标本中的 TILs 进行评估。根据吸烟包年数，利用所有患者的数据计算每位患者的吸烟量。
与低吸烟组相比，高吸烟组的 TILs 密度显著更高（p=0.043），病理完全缓解（pCR）率显著更高（p=0.042）。然而，根据吸烟量，无病生存率（p=0.114）或总生存率（p=0.347）没有显著差异。
吸烟可能会影响 iTME，激活的 iTME 与 pCR 率相关。因此，在这种情况下控制微环境的激活可能有助于改善患者的预后。
