残留肿瘤特征在her2阴性乳腺癌中的预后作用。

Q3 Medicine Experimental oncology Pub Date : 2022-11-01 DOI:10.32471/exp-oncology.2312-8852.vol-44-no-3.18377

L A Sivak, S A Lyalkin, N O Verevkina, A F Shipko

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引用次数: 0

摘要

本研究旨在探讨三阴性(TNBC)和luminal B HER2-neu阴性乳腺癌(LBBC)患者新辅助化疗(NACT)完成后残余肿瘤中免疫生物学标志物(肿瘤浸润淋巴细胞(til)及其亚群)的预后价值。材料与方法:对59例TNBC患者和56例IIB-IIIB期LBBC患者行NACT治疗的结果进行分析。采用免疫组织化学方法研究诊断时患者穿刺活检材料和术后残余肿瘤中TILs及其亚群(FOXP3+、CD4+、CD8+)水平。结果:LBBC患者术前行NACT手术后复发风险主要与FOXP3+淋巴细胞、残余肿瘤Ki-67指数、NACT术后腋窝淋巴结受染数、存活残余肿瘤体积4个因素相关。TNBC患者的治疗结果分析显示，NACT后缺乏病理完全缓解(pCR)使疾病复发的风险增加2.9倍，风险比(HR) = 2.9(95%可信区间(CI) 1.4-6.1;p = 0.005)，与NACT后获得pCR的患者相比。研究还发现，NACT术后TNBC患者的残留肿瘤使该疾病的死亡风险增加2.7倍(95% CI 1.0-7.1;P = 0.05)。NACT术后残余肿瘤中瘤内和间质CD8+淋巴细胞计数的增加显著降低TNBC死亡风险，HR = 0.6 (95% CI 0.5-0.9;p = 0.01)， HR = 0.6 (95% CI 0.4-0.9;P = 0.008)。非pcr组残余肿瘤内CD4+淋巴细胞的增加使TNBC死亡风险降低一半，HR = 0.5 (95% CI 0.3-1.0;P = 0.05)。结论:我们的研究结果表明TILS在TNBC残余肿瘤中具有良好的预后价值。将残留肿瘤中FOXP3+淋巴细胞水平的测定纳入危险人群分层的标准算法也是合理的。

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PROGNOSTIC ROLE OF RESIDUAL TUMOR FEATURES IN HER2-NEGATIVE BREAST CANCER.

The aim of the study was to examine the prognostic value of immunobiological markers (tumor-infiltrating lymphocytes (TILs) and their subpopulations) in residual tumor after neoadjuvant chemotherapy (NACT) completion in patients with triple negative (TNBC) and luminal B HER2-neu negative breast cancer (LBBC).

Materials and methods: The analysis of the treatment results of 59 patients with TNBC and 56 patients with LBBC with stage IIB-IIIB who received NACT was performed. The levels of TILs and their subpopulations (FOXP3+, CD4+, CD8+) in patients at the time of diagnosis in core-needle biopsy material and in residual tumor in postoperative material were studied by immunohistochemical method.

Results: The risk of recurrence in patients with LBBC who received NACT before surgery is associated mainly with 4 factors: FOXP3+ lymphocytes, Ki-67 index in residual tumor, the number of affected axillary lymph nodes after NACT and viable residual tumor volume. Analysis of the treatment outcome in patients with TNBC revealed that the lack of pathologic complete response (pCR) after NACT increases the risk of disease recurrence by 2.9 times, hazard ratio (HR) = 2.9 (95% confidence interval (CI) 1.4-6.1; p = 0.005) compared with patients in which pCR was achieved after NACT. It was also found that the presence of residual tumor in patients with TNBC after NACT increases the risk of death from this disease by 2.7 times (95% CI 1.0-7.1; p = 0.05). Increased intratumoral and stromal CD8+ lymphocyte counts in the residual tumor after NACT significantly reduces the risk of death from TNBC, HR = 0.6 (95% CI 0.5-0.9; p = 0.01) and HR = 0.6 (95% CI 0.4-0.9; p = 0.008), respectively. Increase in intratumoral CD4+ lymphocytes in residual tumor in the non-pCR group reduces by half the risk of death from TNBC, HR = 0.5 (95% CI 0.3-1.0; p = 0.05).

Conclusion: The results of our study indicate a favorable prognostic value of TILS in residual tumor in TNBC. It is also reasonable to include the determination of the level of FOXP3+ lymphocytes in the residual tumor in the standard algorithms for stratification of risk groups.

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来源期刊

Experimental oncology Medicine-Oncology

CiteScore

1.40

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0.00%

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期刊介绍： The Experimental Oncology is an English-language journal that publishes review articles, original contributions, short communications, case reports and technical advances presenting new data in the field of experimental and fundamental oncology. Manuscripts should be written in English, contain original work, which has not been published or submitted for publication elsewhere. It also implies the transfer of the Copyright from the author to “Experimental Oncology”. No part of journal publications may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior permission of the publisher.