肿瘤浸润淋巴细胞在三阴性乳腺癌新辅助化疗预测价值中的研究进展

韩佳雯; 苏婷婷; 徐元兵; 胡超华

doi:10.12354/j.issn.1000-8179.2023.20230567

肿瘤浸润淋巴细胞在三阴性乳腺癌新辅助化疗预测价值中的研究进展

doi: 10.12354/j.issn.1000-8179.2023.20230567

韩佳雯^{1, 2,},
苏婷婷^{1, 2},
徐元兵¹,
胡超华^1, ,

①武汉科技大学附属孝感医院甲状腺乳腺外科（湖北省孝感市432100）
2.
武汉科技大学医学院

基金项目: 本文课题受湖北省科技厅大健康领域重点项目（编号：2022BCE041）和孝感市自然科学基金项目（编号：XGKJ2022010006）资助

详细信息

作者简介:
韩佳雯：专业方向为甲状腺和乳腺肿瘤的诊断与治疗

通讯作者:
胡超华　3043901388@qq.com

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出版历程
- 收稿日期: 2023-06-20
- 录用日期: 2023-10-16
- 修回日期: 2023-10-14

Research progress of tumor infiltrating lymphocytes in predicting the efficacy of neoadjuvant chemotherapy for triple negative breast cancer

Jiawen Han^{1, 2
,},
Tingting Su^{1, 2},
Yuanbing Xu¹,
Chaohua Hu^{1
, ,}

Department of Thyroid and Breast Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Xiaogan 432100, China
2.
Wuhan University of Science and Technology, Wuhan 430065, China

Funds: This work was supported by the Special Fund in the Field of Major Health of the Science and Technology Department of Hubei Province (No. 2022BCE041) and the Natural Science Foundation of Xiaogan City (No. XGKJ2022010006)

More Information

Corresponding author: Chaohua Hu; E-mail:3043901388@qq.com

摘要

摘要: 三阴性乳腺癌（triple negative breast cancer，TNBC）是一种具有高度侵袭性特征的乳腺癌，总体预后不良。肿瘤浸润淋巴细胞（tumor infiltrating lymphocytes，TILs）在肿瘤微环境（tumor microenvironment，TME）中发挥重要作用，可通过细胞免疫调节作用起到对肿瘤细胞增进或抑制。新辅助化疗（neoadjuvant chemotherapy，NAC）是TNBC常见的且有效的治疗手段，其可以通过缩小原发肿瘤达到降期保乳、保腋窝或使“不可手术乳腺癌”转变为“可手术乳腺癌”，为患者治疗提供更多可选的临床思路。目前，TNBC的NAC疗效及预后的预测价值是临床研究的重点和难点，肿瘤浸润淋巴细胞作为重要的生物免疫标志物，在这方面具有较为重要的意义。本文将对TILs在TNBC的NAC疗效及预后方面的预测价值进行综述。
- 肿瘤浸润淋巴细胞 /
- 三阴性乳腺癌 /
- 新辅助化疗 /
- 预测价值
Abstract: Triple negative breast cancer (TNBC) is a type of breast cancer characterized by highly aggressive features and poor overall prognosis. Tumor infiltrating lymphocytes (TILs) play an important role in the tumor microenvironment (TME) and can promote or inhibit tumor cells through the regulation of cellular immunity. Neoadjuvant chemotherapy (NAC) is a common and effective treatment for TNBC that can shrink the primary tumor to downstage advanced breast cancer, achieve axillary conservation, or transform "inoperable breast cancer" into "operable breast cancer", thereby providing patients with a wider range of treatment options. Currently, the predictive value of efficacy and prognosis of neoadjuvant chemotherapy in TNBC is not only the focus but also poses a dilemma in this area of clinical research. In this regard, TILs, as an important cancer biomarker, are of great significance. In this paper, we will review and analyze the predictive value of TILs in the efficacy and prognosis of NAC for TNBC.
- tumor infiltrating lymphocytes (TILs) /
- triple negative breast cancer (TNBC) /
- neoadjuvant chemotherapy (NAC) /
- predictive value

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图 1 肿瘤浸润淋巴细胞分类及作用^[12]

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表 1 TILs与TNBC的NAC相关文献汇总

年份（年）	文献	乳腺癌类型	患者例数（例）	TILs种类	pCR	OS	DFS
2010	Denkert等^[23]	Luminal/ HER-2/TNBC	1 058	CD3D、 CXCL9	42%（训练队列, n=218）； 40%（验证队列，n=840）	—	—
2011	Ono等^[24]	TNBC	180	TILs	32%（TILs高表达）；16%（TILs低表达）	—
2014	Adams等^[25]	TNBC	481	sTILs	—	10.6年70.5%	—
2018	Denkert等^[26]	TNBC	906	TILs	低TILs30%为80例（n=260）；中间TILs31%为117例（n=373）；高TILs50%为136例（n=273）	3年99%	达到pCR5年的DFS为93% 未达到pCR5年的DFS为66%
2019	Luen等^[27]	TNBC	375	CD8⁺T细胞	—	RCBⅡ3年OS率为70%； RCBⅢ3年OS率为32%	3年RFS（RCBⅠ为86%，RCBⅡ为67%，RCBⅢ为26%）
2020	Bai等^[28]	TNBC	74	CD4⁺、CD8⁺、CD20⁺、CD68⁺T细胞	32.4%为24例	5年OS率为86.3%	5年DFS率为81.0%
2020	Lee等^[29]	TNBC	232	TILs	30.8%±24.9%	—	—

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