Sun Hai-Kuan, Jiang Wen-Long, Zhang Shi-Lei, Xu Peng-Cheng, Wei Li-Min, Liu Jiang-Bo
Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China.
World J Clin Oncol. 2024 Jul 24;15(7):920-935. doi: 10.5306/wjco.v15.i7.920.
The association between tumor-infiltrating lymphocyte (TIL) levels and the response to neoadjuvant therapy (NAT) in patients with triple-negative breast cancer (TNBC) remains unclear.
To investigate the predictive potential of TIL levels for the response to NAT in TNBC patients.
A systematic search of the National Center for Biotechnology Information PubMed database was performed to collect relevant published literature prior to August 31, 2023. The correlation between TIL levels and the NAT pathologic complete response (pCR) in TNBC patients was assessed using a systematic review and meta-analysis. Subgroup analysis, sensitivity analysis, and publication bias analysis were also conducted.
A total of 32 studies were included in this meta-analysis. The overall meta-analysis results indicated that the pCR rate after NAT treatment in TNBC patients in the high TIL subgroup was significantly greater than that in patients in the low TIL subgroup (48.0% 27.7%) (risk ratio 2.01; 95% confidence interval 1.77-2.29; < 0.001, = 56%). Subgroup analysis revealed that the between-study heterogeneity originated from differences in study design, TIL level cutoffs, and study populations. Publication bias could have existed in the included studies. The meta-analysis based on different NAT protocols revealed that all TNBC patients with high levels of TILs had a greater rate of pCR after NAT treatment in all protocols (all ≤ 0.01), and there was no significant between-protocol difference in the statistics among the different NAT protocols ( = 0.29). Additionally, sensitivity analysis demonstrated that the overall results of the meta-analysis remained consistent when the included studies were individually excluded.
TILs can serve as a predictor of the response to NAT treatment in TNBC patients. TNBC patients with high levels of TILs exhibit a greater NAT pCR rate than those with low levels of TILs, and this predictive capability is consistent across different NAT regimens.
三阴性乳腺癌（TNBC）患者肿瘤浸润淋巴细胞（TIL）水平与新辅助治疗（NAT）反应之间的关联仍不明确。
探讨TIL水平对TNBC患者NAT反应的预测潜力。
对美国国立生物技术信息中心的PubMed数据库进行系统检索，以收集2023年8月31日前发表的相关文献。采用系统评价和荟萃分析评估TNBC患者TIL水平与NAT病理完全缓解（pCR）之间的相关性。还进行了亚组分析、敏感性分析和发表偏倚分析。
本荟萃分析共纳入32项研究。总体荟萃分析结果表明，高TIL亚组TNBC患者NAT治疗后的pCR率显著高于低TIL亚组患者（48.0%对27.7%）（风险比2.01；95%置信区间1.77 - 2.29；P<0.001，I² = 56%）。亚组分析显示，研究间异质性源于研究设计、TIL水平临界值和研究人群的差异。纳入的研究可能存在发表偏倚。基于不同NAT方案的荟萃分析显示，所有方案中，所有TIL水平高的TNBC患者NAT治疗后的pCR率均更高（所有P≤0.01），不同NAT方案之间的统计学差异无显著性（P = 0.29）。此外，敏感性分析表明，逐个排除纳入的研究时，荟萃分析的总体结果保持一致。
TIL可作为TNBC患者NAT治疗反应的预测指标。TIL水平高的TNBC患者比TIL水平低的患者表现出更高的NAT pCR率，且这种预测能力在不同的NAT方案中是一致的。
