局部晚期乳腺癌：肿瘤浸润淋巴细胞作为新辅助化疗反应的预测因子。
Locally advanced breast cancer: Tumor-infiltrating lymphocytes as a predictive factor of response to neoadjuvant chemotherapy.
机构信息
Breast Service at Luis Razetti Oncology Institute, Caracas, Venezuela.
Breast Service at Luis Razetti Oncology Institute, Caracas, Venezuela.
出版信息
Eur J Surg Oncol. 2019 Jun;45(6):963-968. doi: 10.1016/j.ejso.2019.01.222. Epub 2019 Feb 4.
OBJECTIVE
To evaluate the pathologic response after neoadjuvant chemotherapy in patients with breast cancer according to the stromal tumor-infiltrating lymphocytes (TILs) as well as the evaluation of overall and disease-free survival according to TILs.
METHODS
A six years (2008-2013) review was done including patients with locally advanced breast cancer that received neoadjuvant therapy and then surgery. An evaluation of the percentage of TILs was done in the pretreatment biopsies and a correlation analysis and survival curves were done.
RESULTS
187 patients were evaluated. The pathological complete response (pCR) in patients with TILs ≥30% was 58.5%, and in patients with TILs < 30% was 11% (p <0.001). An Odds Ratio of 8.85 was obtained in patients with TILs ≥30% to achieve a pCR. This relationship was seen in patients with HER2-enriched and triple-negative subtypes. No correlation between TILs and survival was obtained (OS: log-rank; p = 0.834; DFS: log-rank; p = 0.937).
CONCLUSIONS
The study of TILs is important because they represent an additional tool to predict the response to neoadjuvant treatment mostly in HER2-enriched and triple-negative subtypes of breast cancer.
目的
评估乳腺癌患者新辅助化疗后间质肿瘤浸润淋巴细胞（TILs）的病理反应，并根据 TILs 评估总生存和无病生存。
方法
对 6 年（2008-2013 年）期间接受新辅助治疗后行手术的局部晚期乳腺癌患者进行回顾性分析。对预处理活检标本中 TILs 的百分比进行评估，并进行相关性分析和生存曲线分析。
结果
共评估了 187 例患者。TILs≥30%的患者病理完全缓解（pCR）率为 58.5%，而 TILs<30%的患者 pCR 率为 11%（p<0.001）。TILs≥30%的患者达到 pCR 的优势比为 8.85。这种关系在 HER2 富集和三阴性亚型的患者中可见。TILs 与生存无相关性（OS：对数秩；p=0.834；DFS：对数秩；p=0.937）。
结论
TILs 的研究很重要，因为它们是预测新辅助治疗反应的另一种工具，尤其是在 HER2 富集和三阴性乳腺癌亚型中。
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