The Second Affiliated Hospital of Dalian Medical University; Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China.
Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
Theranostics. 2020 Oct 25;10(26):11938-11949. doi: 10.7150/thno.49451. eCollection 2020.
Immune cells have essential auxiliary functions and influence clinical outcomes in cancer, with high immune infiltration being associated with improved clinical outcomes and better response to treatment in breast cancer (BC). However, studies to date have not fully considered the tumor-infiltrating immune cell (TIIC) landscape in tumors. This study investigated potential biomarkers based on TIICs to improve prognosis and treatment effect in BC. We enrolled 5112 patients for analysis and used cell type identification by estimating relative subsets of RNA transcripts (CIBERSORT), a new computational algorithm, to quantify 22 TIICs in primary BC. From the results of univariate Cox regression, 12 immune cells were determined to be significantly related to the overall survival (OS) of BC patients. Furthermore, least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analyses were applied to construct an immune prognostic model based on six potential biomarkers. By dividing patients into low- and high-risk groups, a significant distinction in OS was found in the training cohort, with 20-year survival rates of 42.6% and 26.3%, respectively. Applying a similar protocol to validation and test cohorts, we found that OS was significantly shorter in the high-risk group than in the low-risk group, regardless of the molecular subtype of BC. Using the immune score model to predict the effect of BC patients to chemotherapy, the survival advantage for the low-risk group was evident among those who received chemotherapy, regardless of the chemotherapy regimen. In evaluating the predictive value of the nomogram, a decision curve showed better predictive accuracy than the standard tumor-node-metastasis (TNM) staging system. The immune cell infiltration-based immune score model can be effectively and efficiently used to predict the prognosis of BC patients as well as the effect of chemotherapy.
免疫细胞在癌症中具有重要的辅助功能,并影响临床结局,高免疫浸润与乳腺癌(BC)的临床结局改善和对治疗的更好反应相关。然而,迄今为止的研究并未充分考虑肿瘤浸润免疫细胞(TIIC)在肿瘤中的情况。本研究基于 TIIC 探讨了潜在的生物标志物,以改善 BC 的预后和治疗效果。我们纳入了 5112 名患者进行分析,并使用通过估计 RNA 转录物相对亚群(CIBERSORT)进行细胞类型鉴定的新计算算法来量化原发性 BC 中的 22 种 TIIC。从单变量 Cox 回归的结果中,确定了 12 种免疫细胞与 BC 患者的总生存(OS)显著相关。此外,应用最小绝对收缩和选择算子(LASSO)和多变量 Cox 回归分析构建了基于六个潜在生物标志物的免疫预后模型。通过将患者分为低危和高危组,在训练队列中发现 OS 存在显著差异,20 年生存率分别为 42.6%和 26.3%。应用类似方案对验证和测试队列进行分析,我们发现无论 BC 的分子亚型如何,高危组的 OS 均明显短于低危组。使用免疫评分模型预测 BC 患者对化疗的效果,接受化疗的低危组的生存优势明显,无论化疗方案如何。在评估列线图的预测价值时,决策曲线显示出比标准肿瘤-淋巴结-转移(TNM)分期系统更好的预测准确性。基于免疫细胞浸润的免疫评分模型可有效且高效地用于预测 BC 患者的预后和化疗效果。
Discov Oncol. 2025-8-6