肿瘤浸润淋巴细胞与三阴性乳腺癌预后关系的系统评价  

Systematic evaluation of the relationship between tumor-infiltrating lymphocytes and prognosis of triple negative breast cancer

作　　者：王红卫 赵阳[2] 张帆 范宝珍[1] Wang Hongwei;Zhao Yang;Zhang Fan;Fan Baozhen(Department of Breast,Jingjiang People's Hospital,Jingjiang 214500,China;Department of Burn,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Department of Traditional Chinese Medicine,Jingjiang People's Hospital,Jingjiang 214500,China)

机构地区：[1]靖江市人民医院乳腺外科,214500 [2]新疆医科大学第一附属医院烧伤科,乌鲁木齐830011 [3]靖江市人民医院中医科,214500

出　　处：《国际外科学杂志》2021年第9期609-617,F0003,共10页International Journal of Surgery

摘　　要：目的:探讨肿瘤浸润淋巴细胞(TILs及其表型CD4^(+)TILs、CD8^(+)TILs和FOXP3^(+)TILs对三阴性乳腺癌(TNBC)短期预后[病理完全缓解(PCR)]及长期预后[无病生存期(DFS)、总生存期(OS)]的预后价值,为三阴性乳腺癌(TNBC)的免疫治疗提供理论支持。 方法:计算机检索PubMed、Medline、Embase、Web of Science、中国生物医学文献数据库、中国知网从建库至2020年8月以前发表的所有前瞻性试验和临床观察对照试验。2位作者独立评价纳入文献质量、提取资料,采用RevMan5.3软件进行系统评价和分析。结果:共纳入48篇文献。高表达组TILs及TILs表达每增高10%的患者,预示着有更高的PCR, OR值分别为1.81(95% CI:1.44~2.28)、1.09(95% CI:1.02~1.15);更长的生存时间,DFS的 HR值分别为0.99(95% CI:0.98~0.99)、0.90(95% CI:0.86-0.94),OS的 HR值分别为0.87(95% CI:0.79~0.96)、0.88(95% CI:0.83~0.92)。表型CD4^(+)TILs、CD8^(+)TILs和FOXP3^(+)TILs对患者的PCR差异均无统计学意义,但在长期预后中,浸润程度高预示着患者有更长的生存时间,DFS的 HR值分别为0.54(95% CI:0.36~0.80)、0.46(95% CI:0.33~0.64)、0.45(95% CI:0.31~0.68),OS的 HR值分别为0.49(95% CI:0.32~0.76)、0.59(95% CI:0.54~0.66)、0.44(95% CI:0.27~0.71)。 结论:TILs浸润程度及TILs表达每增高10%可作为TNBC的预后指标;表型CD4^(+)TILs、CD8^(+)TILs、FOXP3^(+)TILs浸润程度高预示着患者有更好的长期生存,但对患者的短期生存差异无统计学意义。Objective:To investigate the prognostic value of tumor infiltrating lymphocytes(TILs)and their phenotypes,CD4^(+)TILs,CD8^(+)TILs and FOXP3^(+)TILs,in short-term prognosis(PCR)and long-term prognosis(DFS,OS)of triple negative breast cancer(TNBC),and to provide theoretical support for the immunotherapy of TNBC.Methods:A systematic surch of PubMed,Medline,Embase,Web of Science,CBM,CNKI was conducted to identified eligible articles.All prospective trials and observational controlled trials published before August 2020 were retrieved.The two authors independently evaluated the quality of the included literature,extracted the data,and conducted systematic evaluation and analysis using RevMan5.3 software.Results:A total of 48 literatures were included.Every 10%increase in TILs and TILs expression in the high-expression group predicted a higher PCR,OR were 1.81(95%CI:1.44-2.28)and 1.09(95%CI:1.02-1.15).For longer survival,the HR for DFS and OS were 0.99(95%CI:0.98-0.99)and 0.90(95%CI:0.86-0.94),0.87(95%CI:0.79-0.96)and 0.88(95%CI:0.83-0.92).Phenotypic CD4^(+)TILs,CD8^(+)TILs,and FOXP3^(+)TILs did not show statistically significant differences in PCR among patients,but in long-term prognosis,higher infiltration predicted longer survival,with HR for DFS of 0.54(95%CI:0.36-0.80),0.46(95%CI:0.33-0.64)and 0.45(95%CI:0.31-0.68).HR of OS were 0.49(95%CI:0.32-0.76),0.59(95%CI:0.54-0.66)and 0.44(95%CI:0.27-0.71).Conclusion:The infiltration degree of TILs and the increase of TILs expression by 10%can be used as a prognostic index of TNBC.High levels of phenotypic infiltration of CD4^(+)TILs,CD8^(+)TILs,and FOXP3^(+)TILs predicted better long-term survival,but there was no statistically significant difference in short-term survival.

关 键 词：三阴性乳腺癌 淋巴细胞 肿瘤浸润 乳腺肿瘤 Meta分析 

分 类 号：R737.9[医药卫生—肿瘤]