Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France;
INSERM U1240 (IMoST), University of Clermont Auvergne, Clermont-Ferrand, France.
Anticancer Res. 2024 Nov;44(11):4983-4994. doi: 10.21873/anticanres.17323.
BACKGROUND/AIM: Triple-negative breast cancer (TNBC) is the most heterogeneous breast cancer subtype, posing numerous challenges in clinical decision-making. Biomarkers are essential to personalize management of TNBC patients. While tumor infiltrating lymphocytes (TILs) are validated prognostic biomarkers, the requirement for tumor biopsy limits their routine use. Therefore, more accessible and reliable quantitative biomarkers are needed. Given the significant role of systemic inflammatory response in tumor onset and progression, assessing inflammatory cells via liquid biopsies emerges as a promising alternative.
The PERCEPTION study, conducted at Centre Jean Perrin in France, aims to determine the correlation between TILs and peripheral blood components at diagnosis. An interim analysis was conducted after enrolling 50% of the estimated population, to evaluate study feasibility and preliminary correlations between blood cell counts and TILs.
Sixty-one patients were enrolled over 4.5 years, demonstrating a good inclusion rate with minimal missing data. Preliminary results for 36 analyzable patients showed no correlation between the neutrophil-to-lymphocyte ratio (NLR) and TILs (r=-0.19, 95%CI=-0.49-0.16, p=0.3). However, a moderate, positive, statistically significant correlation was found between NLR and the CD8/FoxP3 TILs ratio (r=0.36, 95%CI=0.03-0.64, p=0.043). The probabilistic index of 0.7 (p=0.06) between NLR-high and NLR-low groups for this ratio supports the correlation.
The interim analysis of the PERCEPTION study confirms the feasibility of correlating blood cell counts with TILs in TNBC. Although no significant correlation was observed between NLR and TILs, the moderate positive correlation between the CD8/FoxP3 ratio and TILs suggests a potential link between systemic inflammation and local immune response. These findings underscore the potential of blood-based markers as non-invasive surrogates for TILs, encouraging further research to enhance prognosis and guide treatment strategies in TNBC.
背景/目的：三阴性乳腺癌（TNBC）是最具异质性的乳腺癌亚型，在临床决策中带来诸多挑战。生物标志物对于 TNBC 患者的个体化管理至关重要。虽然肿瘤浸润淋巴细胞（TILs）是经过验证的预后生物标志物，但肿瘤活检的需求限制了其常规应用。因此，需要更易于获取和可靠的定量生物标志物。鉴于全身炎症反应在肿瘤发生和进展中的重要作用，通过液体活检评估炎症细胞成为一种有前途的替代方法。
法国让·佩兰中心（Centre Jean Perrin）开展的 PERCEPTION 研究旨在确定诊断时 TILs 与外周血成分之间的相关性。在预计人群的 50%入组后进行了中期分析，以评估研究可行性和 TILs 与血细胞计数之间的初步相关性。
在 4.5 年的时间里共入组了 61 例患者，入组率高，且数据缺失较少。对 36 例可分析患者的初步结果显示，中性粒细胞与淋巴细胞比值（NLR）与 TILs 之间无相关性（r=-0.19，95%CI=-0.49-0.16，p=0.3）。然而，NLR 与 CD8/FoxP3 TILs 比值之间存在中度、正相关、统计学显著相关性（r=0.36，95%CI=0.03-0.64，p=0.043）。NLR 高与 NLR 低组之间该比值的概率指数为 0.7（p=0.06）支持这种相关性。
PERCEPTION 研究的中期分析证实了在 TNBC 中关联血细胞计数与 TILs 的可行性。尽管 NLR 与 TILs 之间未观察到显著相关性，但 CD8/FoxP3 比值与 TILs 之间的中度正相关性提示全身炎症与局部免疫反应之间可能存在关联。这些发现强调了基于血液的标志物作为 TILs 非侵入性替代标志物的潜力，鼓励进一步研究以增强 TNBC 的预后并指导治疗策略。
