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三阴性乳腺癌的预后因素与肿瘤浸润淋巴细胞

Prognostic Factors and Tumor Infiltrating Lymphocytes in Triple Negative Breast Cancer.

作者信息

Dülgar Özgecan, İlvan Şennur, Turna Zeynep Hande

机构信息

Departmant of Medical Oncology, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey.

Deptartment of Pathology, İstanbul University-Cerrahpaşa, Cerrahpasa School of Medicine, İstanbul, Turkey.

出版信息

Eur J Breast Health. 2020 Apr 17;16(4):276-281. doi: 10.5152/ejbh.2020.5305. eCollection 2020 Oct.

Abstract

OBJECTIVE

Triple-negative-breast-cancer (TNBC) is a very heterogenous disease some of which are very aggressive and have poor prognosis. No targeted therapy is available. Immune response and tumor-infiltrating lymphocytes (TIL) can be related to longer disease-free survival (DFS) and overall survival (OS) in TNBC. Family history of cancer can be related poor prognosis, irrespective of genetic mutation.

MATERIALS AND METHODS

Pathology reports and files of 167 patients operated for TNBC were assessed retrospectively. The effects of lymphocyte infiltration, family history of cancer and other tumor characteristics on prognosis were evaluated. Data of 137 patients was included in statistical analysis.

RESULTS

Univariate-analysis revealed that stage, size of tumor, histological subtype, number of infiltrated axillary lymph-nodes, lymphatic and vascular invasion, choice of adjuvant/neoadjuvant chemotherapy, family history of cancer has a statistically significant effect on DFS. Increase in density of lymphocyte infiltration of tumor has also better a prognostic effect on DFS (p=0.02). In multivariate-analysis, only tumor size and choice of adjuvant/neoadjuvant chemotherapy are found to have statistically significant effect.

CONCLUSION

Tumor lymphocyte infiltration was found to have a statistically significant better prognostic effect on DFS but not on OS of patients with operated TNBC. This result can be due to variability of therapies administered after recurrence and other confounding factors that may have an effect on OS.

摘要

目的

三阴性乳腺癌(TNBC)是一种异质性很强的疾病,其中一些具有很强的侵袭性且预后较差。目前尚无靶向治疗方法。免疫反应和肿瘤浸润淋巴细胞(TIL)可能与TNBC患者更长的无病生存期(DFS)和总生存期(OS)相关。癌症家族史可能与预后不良有关,无论是否存在基因突变。

材料与方法

回顾性评估167例接受TNBC手术患者的病理报告和病历。评估淋巴细胞浸润、癌症家族史及其他肿瘤特征对预后的影响。137例患者的数据纳入统计分析。

结果

单因素分析显示,分期、肿瘤大小、组织学亚型、腋窝淋巴结转移数目、淋巴管和血管侵犯、辅助/新辅助化疗方案、癌症家族史对DFS有统计学显著影响。肿瘤淋巴细胞浸润密度增加对DFS也有较好的预后作用(p=0.02)。多因素分析中,仅发现肿瘤大小和辅助/新辅助化疗方案有统计学显著影响。

结论

对于接受手术的TNBC患者,肿瘤淋巴细胞浸润对DFS有统计学显著的更好预后作用,但对OS无此作用。这一结果可能归因于复发后所采用治疗方法的差异以及其他可能影响OS的混杂因素。

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