Farolfi Alberto, Petracci Elisabetta, Serra Luigi, Ravaioli Alessandra, Bravaccini Sara, Ravaioli Sara, Tumedei Maria Maddalena, Ulivi Paola, Canale Matteo, Puccetti Maurizio, Falcini Fabio, Folli Secondo, Curcio Annalisa, Rocca Andrea
Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
Front Oncol. 2020 Aug 19;10:1486. doi: 10.3389/fonc.2020.01486. eCollection 2020.
Women with a diagnosis of ductal carcinoma (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% and >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 ( = 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, = 0.016). Although we did not find any significant association between TILs and SBE, further studies evaluating their role according to radiotherapy are warranted.
被诊断为导管原位癌（DCIS）的女性发生第二次乳腺事件（SBE）的风险很高。免疫系统可能在试图预防SBE中发挥作用。1997年至2010年期间，在大区瓦萨罗马涅基于人群的癌症登记处中识别出被诊断为DCIS的患者。中位随访时间为8.5年。对原发性DCIS和SBE中的肿瘤浸润淋巴细胞（TILs）进行了评估。主要终点是评估原发性DCIS中TILs水平与SBE风险之间的关联。在496例DCIS患者中，识别出100例SBE（20.2%）：55例同侧（11.1%）和43例对侧（8.7%）。TILs的分布是异质性的，但与分级、坏死、筛查发现和手术类型显著相关。根据TILs百分比（≤5%和>5%）分层的患者在SBE的5年累积发病率上没有显示出统计学上的显著差异：分别为14.9%（95%CI 11.3 - 19.1）和11.0%（95%CI，6.9 - 16.2）（P = 0.147）。在未接受放疗的患者亚组中，TILs>5%与SBE风险降低相关（HR 0.34，95%CI 0.14 - 0.82，P = 0.016）。尽管我们没有发现TILs与SBE之间有任何显著关联，但有必要进一步研究根据放疗评估它们的作用。
