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Lancet oncol：肿瘤浸润淋巴细胞（TIL）与不同亚型的乳腺癌预后的关系。

2017-12-08 MedSci MedSci原创

肿瘤浸润淋巴细胞乳腺癌预后HER2
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肿瘤浸润淋巴细胞（TILs）可预测三阴乳腺癌（TNBC）和HER2炎性乳腺癌对新辅助化疗的反应性，但其在导管性乳腺癌中的作用以及TILs对所有亚型预后的影响尚不是很清楚。近期Lancet子刊上发表一篇文章，研究人员对TILs与TNBC、HER2阳性乳腺癌和HER2阴性的导管性乳腺癌患者对化疗的敏感性和预后之间的关联进行评估。从德国乳腺癌学会所做的6个随机试验中筛选进行新辅助化疗的原发乳腺癌患者。初

肿瘤浸润淋巴细胞（TILs）可预测三阴乳腺癌（TNBC）和HER2炎性乳腺癌对新辅助化疗的反应性，但其在导管性乳腺癌中的作用以及TILs对所有亚型预后的影响尚不是很清楚。近期Lancet子刊上发表一篇文章，研究人员对TILs与TNBC、HER2阳性乳腺癌和HER2阴性的导管性乳腺癌患者对化疗的敏感性和预后之间的关联进行评估。

从德国乳腺癌学会所做的6个随机试验中筛选进行新辅助化疗的原发乳腺癌患者。初筛3771名患者，统计其治疗前活检组织中心的基质TILs的数量。将TILs既作为连续参数进行分析，并根据其将患者分组：低TILs（肿瘤内基质组织中免疫细胞占0-10%）、中TILs（11-59%）和高TILs（≥60%）。研究人员分别有单变量模型和多变量模型处理数据，在几个临床试验队列的2560位患者中评估TIL浓度与所有患者的病理性完全反应、TILs数量与病程无进展存活期以及总体存活率之间的关系。

对于HER2阴性的导管性乳腺癌亚型，低TILs、中TILs和高TILs患者获得病理性完全反应（pCR）的比例分别是6%（45/759）、11%（48/435）和28%（49/172）。对于HER2阳性乳腺癌亚型，低TILs、中TILs和高TILs患者获得pCR的比例分别是32%（194/605）、39%（198/512）和48%（127/262）。最后，对于TNBC乳腺癌亚型，低TILs、中TILs和高TILs患者获得pCR的比例分别是31%（80/260）、31%（117/373）和50%（136/273）（所有亚型p<0.0001）。在单变量分析中，TILs增加10%，即可延长TNBC和HER2阳性乳腺癌患者的无进展存活期（TNBC:危险比[HR]0.93[95% CI 0.87-0.98],p=0.011;HER2+：0.94[0.89-0.99],p=0.017），但对HER2阴性的导管性乳腺癌则无明显影响（1.02[0.96-1.09],p=0.46）。TILs增加，还可延长TNBC患者的总体存活期（0.92[0.86-0.99],p=0.032）,但对HER2阳性的乳腺癌患者的存活期无明显影响（0.94[0.86-1.02],p=0.11）,此外，TILs增加，与HER2阴性的导管性乳腺癌患者总体存活期缩短相关（1.10[1.02-1.10],p=0.011）。

对于所有评估的分子亚型，TIL浓度增加，可增加对新辅助化疗的反应性，而且与HER2阳性和TNBC乳腺癌患者的生存期延长相关。相关的，TILs升高，是HER2阴性的导管性乳腺癌患者的负面预测因子，提示对于该亚型，存在不同的免疫学渗透。研究数据支持乳腺癌具有免疫原性这一假说，或可采取免疫调节疗法治疗乳腺癌。

原始出处：

Carsten Denkert,et al.Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: a pooled analysis of 3771 patients treated with neoadjuvant therapy.The Lancet Oncology.07 December 2017. http://dx.doi.org/10.1016/S1470-2045(17)30904-X

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    2018-05-02 howi

    #Lancet#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1829363, encodeId=deb61829363db, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Wed May 02 01:36:00 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865231, encodeId=6568186523194, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Feb 13 19:36:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268772, encodeId=11b8268e722e, content=一起学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Tue Dec 12 06:53:48 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302120, encodeId=b2501302120e7, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sun Dec 10 06:36:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267930, encodeId=280f26e9300f, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Fri Dec 08 23:19:37 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
    2018-02-13 minlingfeng

    #Oncol#

    0

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    2017-12-12 wzb521zf

    一起学习一下

    0

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    2017-12-10 wetgdt

    #淋巴细胞#

    0

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    2017-12-08 天涯183

    非常好的文章.学习了

    0

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胰腺导管腺癌（PDAC）患者预后极差，需要疗效更好的治疗方法。肿瘤浸润淋巴细胞（TIL）过继细胞疗法（ACT）在其他肿瘤中表现出了良好的治疗效果。如在转移性黑色素瘤中出现过50%的总反应率。T细胞功能与胰腺癌患者总生存正相关。CLIN CANCER RES近期发表了一篇文章，研究增强CD8+TIL细胞识别自体肿瘤抗原的能力。此外还研究了肿瘤微环境中CD8+TIL的亚型和T细胞受体情况。