Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Oncol. 2023 Dec;62(12):1862-1872. doi: 10.1080/0284186X.2023.2274483. Epub 2023 Nov 25.
Response rates vary among breast cancer patients treated with neoadjuvant systemic therapy (NAST). Thus, there is a need for reliable treatment predictors. Evidence suggests tumor-infiltrating lymphocytes (TILs) predict NAST response. Still, TILs are seldom used clinically as a treatment determinant. Mammographic density (MD) is another potential marker for NAST benefit and its relationship with TILs is unknown. Our aims were to investigate TILs and MD as predictors of NAST response and to study the unexplored relationship between TILs and MD.
We studied 315 invasive breast carcinomas treated with NAST between 2013 and 2020. Clinicopathological data were retrieved from medical records. The endpoint was defined as pathological complete response (pCR) in the breast. TILs were evaluated in pre-treatment core biopsies and categorized as high (≥10%) or low (<10%). MD was scored (-) according to the breast imaging reporting and data system (BI-RADS) fifth edition. Binary logistic regression and Spearman's test of correlation were performed using SPSS.
Out of 315 carcinomas, 136 achieved pCR. 94 carcinomas had high TILs and 215 had low TILs. Six carcinomas had no available TIL data. The number of carcinomas in each BI-RADS category were 37, 122, 112, and 44 for , , , and , respectively. High TILs were independently associated with pCR (OR: 2.95; 95% CI: 1.59-5.46) compared to low TILs. In the univariable analysis, MD (BI-RADS vs. ) showed a tendency of higher likelihood for pCR (OR: 2.43; 95% CI: 0.99-5.98). However, the association was non-significant, which is consistent with the result of the multivariable analysis (OR: 2.51; 95% CI: 0.78-8.04). We found no correlation between TILs and MD (0.02; = .80).
TILs significantly predicted NAST response. We could not define MD as a significant predictor of NAST response. These findings should be further replicated.
接受新辅助全身治疗 (NAST) 的乳腺癌患者的缓解率各不相同。因此，需要可靠的治疗预测指标。有证据表明肿瘤浸润淋巴细胞 (TIL) 可预测 NAST 反应。尽管如此，TIL 很少在临床上用作治疗决定因素。乳腺密度 (MD) 是 NAST 获益的另一个潜在标志物，但其与 TILs 的关系尚不清楚。我们的目的是研究 TILs 和 MD 作为 NAST 反应的预测指标，并研究 TILs 和 MD 之间尚未探索的关系。
我们研究了 2013 年至 2020 年间接受 NAST 治疗的 315 例浸润性乳腺癌。临床病理数据从病历中检索。终点定义为乳房的病理完全缓解 (pCR)。TILs 在预处理核心活检中进行评估，并分为高 (≥10%) 或低 (<10%)。根据乳腺成像报告和数据系统 (BI-RADS) 第五版，MD 评分为 (-)。使用 SPSS 进行二元逻辑回归和 Spearman 相关检验。
在 315 例癌中，有 136 例达到 pCR。94 例有高 TILs，215 例有低 TILs。有 6 例癌没有可用的 TIL 数据。BI-RADS 各分类的癌数分别为 37、122、112 和 44 例，分别为、、、。与低 TILs 相比，高 TILs 与 pCR 独立相关 (OR：2.95；95% CI：1.59-5.46)。在单变量分析中，MD (BI-RADS 与 ) 显示出更高 pCR 可能性的趋势 (OR：2.43；95% CI：0.99-5.98)。然而，该关联无统计学意义，这与多变量分析的结果一致 (OR：2.51；95% CI：0.78-8.04)。我们没有发现 TILs 和 MD 之间存在相关性 (0.02；=.80)。
TILs 显著预测了 NAST 反应。我们不能将 MD 定义为 NAST 反应的重要预测指标。这些发现应进一步复制。
