首页|FOXP3+肿瘤浸润性淋巴细胞与乳腺癌病理特征和预后的相关性研究

FOXP3+肿瘤浸润性淋巴细胞与乳腺癌病理特征和预后的相关性研究

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目的 探讨FOXP3+肿瘤浸润性淋巴细胞(TILs)与乳腺癌临床病理特征之间的相关性及其预后的意义.方法 选取2009 年 1 月至 2013 年 5 月期间首都医科大学附属北京世纪坛医院治疗的 156 例浸润性乳腺癌患者,采用免疫组化方法检测FOXP3+和CD4+的蛋白表达,记录患者的年龄、肿瘤大小、肿瘤分期、淋巴结转移情况、组织学分级、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)、Ki-67 指数、无病生存(DFS)率和总生存(OS)率,探讨FOXP3+TILs与临床病理特征之间的相关性,使用Kaplan-Meier曲线和Cox比例风险模型进行生存分析.结果 156 例浸润性乳腺癌患者的中位年龄为 51 岁(32～70 岁),乳腺癌组织中,FOXP3+高表达的患者 51 例(32.7%),FOXP3+的表达在肿瘤的组织学分级(P=0.021)、PR(P=0.016)、HER-2(P=0.018)、Ki-67 指数(P=0.042)、腋窝淋巴结转移(P=0.001)方面的差异均有统计学意义.CD4+TILs的表达与所有患者的临床病理特征均无明显相关性.生存分析显示,FOXP3+高表达患者的OS率低于FOXP3+低表达患者的OS率(64.7%比 87.6%,χ2=15.3,P<0.001).FOXP3+高表达患者的 DFS率也低于低表达患者的 DFS率(56.9%比 80.0%,χ2=13.1,P<0.001),差异有统计学意义.在 74 例腋窝淋巴结转移阳性的患者中,FOXP3+高表达患者的DFS率低于FOXP3+低表达患者的DFS率,差异有统计学意义(χ2=5.730,P<0.001).在多因素Cox生存分析显示,FOXP3+TILs是乳腺癌患者 OS[HR=2.732(95%CI=1.174～6.207),P=0.023]和 DFS[HR=2.092(95%CI=1.068～4.088),P=0.032]预后不良的独立影响因素.结论 FOXP3+高表达患者的OS率和DFS率均低于FOXP3+低表达患者,FOXP3+TILs可作为乳腺癌患者的独立不良预后因素.
Association of FOXP3+tumor infiltrating lymphocytes with poor prognosis of primary breast cancer:a retrospective cohort study
Objective To detect the expression of FOXP3+TILs in primary invasive breast cancer,analyze the correlation between the expression level of FOXP3+TILs and the clinicopathological characteristics of breast cancer,and explore the relationship between FOXP3+TILs and the prognosis of breast cancer.Method Surgically resected samples from 156 patients with invasive breast cancer(BC)were assessed for the expression of FOXP3+TILs and CD4+TILs by immunohistochemistry.The correlation between FOXP3+TILs and the patients'clinicopathological characteristics was explored.Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to assess the correlation between FOXP3+TILs and breast cancer-specific survival,and to stratify the evaluation of breast cancer subtypes.Result Elevated FOXP3+TILs infiltration were significantly correlated with high histological grade(P=0.021),positive human epidermal growth factor receptor-2(HER-2)(P=0.018),Progesterone receptor expression(PR)(P=0.016),high Ki-67 index(P=0.042)and axillary lymph node metastases(P=0.001).There was no significant correlation between CD4+TILs expression and the clinicopathological features of all patients.Tumors with concomitant high expressions of FOXP3+TILs had worse overall survival(OS)and disease-free survival(DFS)(64.7%vs 87.6%,χ2=15.3,P<0.001;56.9%vs 80.0%,χ2=13.1,P<0.001).The patients with axillary lymph node metastases with the high expressions of FOXP3+TILs infiltration had worse DFS(P<0.001).Multivariate analysis showed that FOXP3+TILs was independent predictors of OS(HR=2.732,95%CI=1.174～6.207,P=0.023)and DFS(HR=2.092,95%CI=1.068～4.088,P=0.032).Conclusion The high expression of FOXP3+TILs in breast cancer is associated with tumor progression,higher expression of FOXP3+TILs indicates wores OS and DFS,FOXP3+TILs maybe a prognostic marker for breast cancer.

Breast cancerFOXP3+tumor infiltrating lymphocyteOverall survivalDisease-free survival

赵霞、李艳萍、冯宇、吕淑贞

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首都医科大学附属北京世纪坛医院乳腺中心,北京 100038

乳腺癌 FOXP3+肿瘤浸润性淋巴细胞 总生存 无病生存

2024

10.16689/j.cnki.cn11-9349/r.2024.03.020

肿瘤代谢与营养电子杂志

肿瘤代谢与营养电子杂志

CSTPCD
ISSN：
年,卷(期)：2024.11(3)