Effect of tumor-stroma ratio and stromal tumor-infiltrating lymphocytes on the efficacy of neoadjuvant therapy for HER2-negative breast cancer
Purpose To investigate the predictive signifi-cance of tumor-stroma ratio(TSR)and stromal tumor-infiltrating lymphocytes(sTILs)in neoadjuvant therapy(NAT)for HER2-negative breast cancer.Methods A total of 516 patients with HER2-negative invasive breast cancer by preoperative puncture were collected,and all of them underwent radical surgery after receiving NAT.TSR and sTILs in breast cancer tissue were eval-uated on routine HE sections of biopsy,and residual cancer bur-den(RCB)grading,Miller-Payne(MP)grading and pathologi-cal complete response(pCR)assessment were carried out in postoperative specimens.Associations between the TSR,sTILs,TSR combined with sTILs and clinicopathological features were examined using Pearson's chi-square,and the relationships with chemotherapy response were analyzed by linear by linear associa-tion.Logistic binary regression analysis was used to analyze the association between TSR,sTILs,TSR combined with sTILs and pCR rate.Results Among the 516 cases of breast cancer,278 cases(53.9％)had a high TSR(tumor stromal area≤50％)and 238 cases(46.1％)had a low TSR(tumor stromal area＞50％).Tumors in TSR-high groups and sTILs-high groups be-fore NAT were significantly associated with higher MP grade and lower RCB grade,as well as higher pCR rate(P＜0.05).The probability of obtaining pCR in patients with high TSR in preop-erative biopsy was 2.163 times higher than that in patients with low TSR(OR:2.163,95％CI:1.201-3.898,P=0.010).In the hormone receptor(HR)-negative group,the OR value of pCR rate in patients with high TSR was 2.999(95％CI:1.216-7.396,P=0.017).The pCR rate after NAT in patients with TSR-high and sTILs-high groups was 4.052 times higher than that in patients with TSR-low and sTILs-low(OR:4.052,95％CI:1.900-8.644,P＜0.001),and the difference was statis-tically significant.Conclusion Higher TSR and sTILs status in pretreatment biopsies of HER2-negative breast cancer patients are associated with higher MP grade,lower RCB grade and high-er pCR rate after NAT,and preoperative joint evaluation of both can provide some help for clinical treatment.
breast neoplasmHER2-negative breast cancerneoadjuvant therapytumor-stroma ratiostromal tumor-infiltra-ting lymphocytesresidual cancer burdenpathological complete response
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维普
