Ménard S, Tomasic G, Casalini P, Balsari A, Pilotti S, Cascinelli N, Salvadori B, Colnaghi M I, Rilke F
Experimental Oncology, General Direction, Istituto Nazionale per lo Studio e la Cura dei Tumori, University of Milan, 20133 Milan, Italy.
Clin Cancer Res. 1997 May;3(5):817-9.
Infiltration by lymphoid cells is a common feature of many human tumors, including breast carcinomas, and the degree of infiltration has been suggested to be a measure of the host immune response. Our analyses in a series of 1919 cases of primary ductal and lobular infiltrating breast carcinomas from women with a long-term follow-up revealed: (a) a 16-17% frequency of infiltrated tumors independent of the patient's age at diagnosis; and (b) a strong positive correlation between survival rates and the presence of lymphocytes at the tumor site in patients less than 40 years of age (P = 0.0002) but no association with prognosis in patients 40 years of age or older. Multivariate analysis indicated that lymphoid infiltration is independent of other conventional prognostic factors such as nodal status and tumor size in predicting survival. Thus, a possible immune response against the tumor seems to be relevant only in women with early-onset tumors. Because the immune system is functionally maximum in younger years, declining with age, this finding might reflect a difference in the efficiency of the immune system. Alternatively, the biology of these tumors might differ, leading to a difference in immuno-genicity.
淋巴细胞浸润是包括乳腺癌在内的许多人类肿瘤的常见特征，浸润程度被认为是宿主免疫反应的一种度量。我们对1919例原发性导管和小叶浸润性乳腺癌患者进行了长期随访分析，结果显示：（a）浸润性肿瘤的发生率为16 - 17%，与诊断时患者的年龄无关；（b）年龄小于40岁的患者，生存率与肿瘤部位淋巴细胞的存在呈强正相关（P = 0.0002），但40岁及以上患者的预后与之无关。多因素分析表明，在预测生存方面，淋巴浸润独立于其他传统预后因素，如淋巴结状态和肿瘤大小。因此，针对肿瘤的可能免疫反应似乎仅在早发性肿瘤的女性中具有相关性。由于免疫系统在年轻时功能最强，随年龄增长而衰退，这一发现可能反映了免疫系统效率的差异。或者，这些肿瘤的生物学特性可能不同，导致免疫原性存在差异。
