Zhang Lina, Tang Tiantian, Liu Lei, Li Chunxiao, Li Yuntao, Geng Cuizhi
Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Front Oncol. 2023 Aug 4;13:1175965. doi: 10.3389/fonc.2023.1175965. eCollection 2023.
Currently, it remains unclear regarding the association between tumor-infiltrating lymphocytes (TILs) and the efficacy of postoperative radiotherapy in primary tumors. Here we attempted to investigate the effect of TILs depending on the presence of postmastectomy radiotherapy (PMRT) on the prognosis in pT1-2N1M0 breast cancer.
The clinical data of pT1-2N1M0 breast cancer patients undergoing mastectomy and axillary lymph node dissection were retrospectively analyzed. The effect of TILs on the prognosis was assessed based on the infiltration degree (low: TILs ≤10%, high: TILs >10%), and then the prognosis of patients with low and high infiltration of TILs was analyzed based on presence or absence of PMRT.
Totally 213 patients were eligible for the study, including 162 cases of low infiltration and 51 of high infiltration. High-infiltration patients tended to be ER/PR-negative, HER2-positive, and have high histological grade. The infiltration in triple-negative and HER2-positive subtypes was higher compared with Luminal A subtype. Regarding local-regional recurrence-free survival, recurrence-free survival, and overall survival (OS) rates, the differences were all inapparent whether in high- and low-infiltration patients or in high-infiltration patients with/without PMRT. Compared with those without PMRT, low-infiltration patients with PMRT showed a significantly increased OS rate (92.8% 80.0%, =0.023). Multivariate analysis further confirmed PMRT as an independent predicator of OS in low-infiltration patients (HR: 0.228, 95%CI: 0.081-0.644, =0.005).
High infiltration of TILs in pT1-2N1M0 breast cancer may be associated with clinicopathological factors. Low-infiltration patients, but not high-infiltration patients, may derive survival benefits from PMRT.
目前，肿瘤浸润淋巴细胞（TILs）与原发性肿瘤术后放疗疗效之间的关联尚不清楚。在此，我们试图研究TILs的影响，并依据保乳术后放疗（PMRT）的存在情况，探讨其对pT1-2N1M0期乳腺癌预后的影响。
回顾性分析接受乳房切除术和腋窝淋巴结清扫术的pT1-2N1M0期乳腺癌患者的临床资料。根据浸润程度（低：TILs≤10%，高：TILs>10%）评估TILs对预后的影响，然后基于是否存在PMRT分析TILs低浸润和高浸润患者的预后。
共有213例患者符合研究条件，其中低浸润162例，高浸润51例。高浸润患者倾向于雌激素受体/孕激素受体（ER/PR）阴性、人表皮生长因子受体2（HER2）阳性，且组织学分级高。三阴型和HER2阳性亚型的浸润高于Luminal A亚型。关于局部区域无复发生存率、无复发生存率和总生存率（OS），无论是高浸润和低浸润患者，还是接受或未接受PMRT的高浸润患者，差异均不明显。与未接受PMRT的患者相比，接受PMRT的低浸润患者的OS率显著提高（92.8%对80.0%，P=0.023）。多因素分析进一步证实PMRT是低浸润患者OS的独立预测因素（风险比：0.228，95%置信区间：0.081-0.644，P=0.005）。
pT1-2N1M0期乳腺癌中TILs的高浸润可能与临床病理因素有关。低浸润患者而非高浸润患者可能从PMRT中获得生存益处。
