肿瘤浸润淋巴细胞及肿瘤细胞EGFR蛋白表达在三阴性乳腺癌患者中的预后价值  

Prognostic Value of Tumor Infiltrating-Lymphocytes and EGFR Protein Expression of Tumor Cell in Patients with Triple-Negative Breast Cancer

作　　者：张丹丹[1] 赵静[1] 曾满芹 孟婷[1] 董娴宁[1] 付广明[1] 魏志敏[1] 

机构地区：[1]青岛大学附属医院病理科,山东 青岛

出　　处：《临床医学进展》2022年第6期5331-5342,共12页Advances in Clinical Medicine

摘　　要：与Luminal型乳腺癌、人类表皮生长因子受体2 (HER2) (+)乳腺癌相比,三阴性乳腺癌(Triple-Negative Breast Cancer, TNBC)缺乏靶向治疗的特异性靶点,具有生物学侵袭性、复发转移风险高、生存期较短等特点。目的:评估肿瘤浸润淋巴细胞(Tumor Infiltrating-Lymphocytes, TILs)与表皮生长因子受体(EGFR)表达的预后价值,并确定它们与TNBC的临床病理参数之间的关系。材料与方法:收集2010年1月至2015年12月共计70例于青岛大学附属医院接受手术治疗的、有病理报告和临床资料完整的TNBC患者。评估手术标本中TILs比例,并分为高比例(TILs ≥ 40%,n = 28)和低比例(TILs < 40%,n = 42) 2组。免疫组化检测ER、PR、HER2和EGFR的表达,评估EGFR表达情况,并将其分为强阳性组(EGFR ≥ 50%,n = 10)和非强阳性组(EGFR < 50%,n = 60)。评估TILs比例和EGFR表达对预后的影响。结果:TILs低比例组中位无病生存期(DFS) 55.5个月,TILs高比例组97个月,两组比较p = 0.059;TILs低比例组中位总生存期(OS) 69.5个月,高比例组97个月,p = 0.084。EGFR非强阳性组,低比例TILs (TILs < 40%, n = 25)中位DFS和OS分别为24个月和36个月,高比例TILs (TILs ≥ 40%, n = 35)中位DFS和OS均为96个月,不同TILs比例组之间DFS (p = 0.035)和OS (p = 0.048)具有统计学显著性差异;EGFR强阳性组,低比例TILs (TILs < 40%, n = 7)中位DFS和OS均为98个月,高比例TILs (TILs ≥ 40%, n = 3)中位DFS和OS均为94个月(p = 0.513和p = 0.882)。结论:不同TILs比例三阴性乳腺癌患者治疗后DFS和OS差别无统计学显著性。EGFR非强阳性的TNBC患者,TILs比例越高、术后DFS和OS均越长。Compared with Luminal breast cancer and HER2 (+) breast cancer, triple-negative breast cancer (TNBC) lacks specific targets for targeted therapy, and is characterized by biological invasions, high risk of recurrence and metastasis, and short survival. Objective: To evaluate the prognostic value of tumor infiltrating-lymphocytes (TILs) and epidermal growth factor receptor (EGFR) expression, and to determine their relationship with clinicopathological parameters of TNBC. Materials and Methods: 70 TNBC patients with complete pathological reports and clinical data between January 2010 to December 2015 in Affiliated Hospital of Qingdao University were selected. TILs proportions in sur-gical specimens were assessed and divided into high (TILs ≥ 40%, n = 28) and low groups (TILs < 40%, n = 42). The expression of ER, PR, HER2 and EGFR were detected by immunohistochemistry. EGFR expression was evaluated and divided into strongly positive group (EGFR ≥ 50%, n = 10) and non-strongly positive group (EGFR < 50%, n = 60). The effect of TILs ratio and EGFR expression on prognosis was evaluated. Results: Median disease-free survival (DFS) and total survival (OS) were 55.5 and 69.5 months, respectively, in the low-proportion TILs group, and both of them were 97 months in the high-proportion TILs group. There were no statistically significant differences in DFS (p = 0.059) and OS (p = 0.084) in different TILs proportion groups. In EGFR non-strongly positive group, median DFS and OS were 24 and 36 months, respectively, in the low-proportion TILs group (TILs < 40%, n = 25). Median DFS and OS were 96 months in the high-proportion TILs group (TILs ≥ 40%, n = 35). There were statistically significant differences in DFS (p = 0.035) and OS (p = 0.048) in different TILs proportion groups. In EGFR positive group, median DFS and OS were 98 months in the low-proportion TILs group (TILs < 40%, n = 7), and median DFS and OS were 94 months in the high-proportion TILs (TILs ≥ 40%, n = 3) (p = 0.513 and p = 0.882). Conclusion: TILs ratio

关 键 词：肿瘤浸润淋巴细胞 表皮生长因子受体 三阴性乳腺癌 总体生存时间 无病生存时间 预后 

分 类 号：R737.9[医药卫生—肿瘤]