摘要
目的 探讨肿瘤间质比(tumor-stroma ratio,TSR)联合纤维化中心(fibrotic focus,FF)、肿瘤间质浸润淋巴细胞(stromal tumor-infiltrating lymphocytes,sTILs)与三阴型乳腺癌(triple-negative breast cancer,TNBC)新辅助治疗后病理完全缓解(patho-logical complete response,pCR)的相关性和预后价值.方法 收集170例TNBC的临床资料,由两位高年资病理医师采用双盲法阅片,复核所有病例的病检资料,评估TSR、FF、sTILs结果和CD4、CD8的表达,分析其与pCR、预后的关系.结果 170例TNBC 经新辅助治疗后 57 例为 pCR,113 例为非 pCR(non-pCR).pCR 组和 non-pCR 组中 TSR、FF、sTILs、CD4、CD8、Ki67、脉管内癌栓、淋巴结转移差异有统计学意义;不同Miller-Payne(MP)分级中TSR、FF和sTILs差异也有统计学意义.TSR、sTILs、TSR联合FF、TSR联合sTILs、Ki67与pCR呈正相关;同时,前三者还与MP分级呈正相关,而FF、脉管内癌栓、淋巴结转移与pCR呈负相关,且FF与MP分级也呈负相关;TSR＞1、G0 FF和sTILs＞50％时患者的预后最佳;TSR联合FF、sTILs时pCR组预后均优于non-PCR组.结论 TSR、FF、sTILs有望成为预测TNBC新辅助治疗疗效及预后的指标,为TNBC患者的治疗和科研提供新思路.
Abstract
Purpose To investigate the correlation and prognostic value of tumor-stroma ratio(TSR)combined with fi-brotic focus(FF)and stromal tumor-infiltrating lymphocytes(sTILs)with pathological complete response(pCR)after neoad-juvant therapy in triple-negative breast cancer(TNBC).Meth-ods The clinical data of 170 cases of TNBC were collected.Af-ter double-blind reading of the sections by two senior patholo-gists,the pathological examination results of all cases were re-viewed,and the results of TSR,FF,sTILs and the expression of CD4 and CD8 were evaluated.Then the relationship between the above information and PCR and prognosis was analyzed.Results 170 cases of TNBC after neoadjuvant therapy,57 patients a-chieved pCR,while 113 patients did not achieve pCR.Statistical analysis revealed the following findings:TSR,FF,sTILs,CD4,CD8,Ki67,vascular invasion,and lymph node metastasis exhib-ited significant differences between the pCR and non-pCR groups.There were also significant differences in TSR,FF and sTILs between different Miller-Payne(MP)grades.TSR,sTILs,TSR combined with FF,sTILs and Ki67 were positively correlated with PCR.Meanwhile,TSR,sTILs,TSR combined with FF and sTILs were also positively correlated with MP grade,while FF,intravascular tumor thrombus and lymph node metasta-sis were negatively correlated with PCR.At the same time,TSR and sTILs were also positively correlated with MP grade,and FF was also negatively correlated with MP grade.The prognosis of patients was optimal with TSR＞1,G0 FF and sTILs＞50％.When TSR combined with FF and sTILs,the prognosis of PCR group was better than that of non-PCR group.Conclusion TSR,FF,and sTILs are anticipated to serve as predictive bio-markers for assessing the efficacy and prognosis of neoadjuvant therapy in TNBC patients.These findings offer novel insights into the treatment and research strategies for TNBC.
维普
万方数据