背景:在三阴性乳腺癌(TNBC)中,间质瘤浸润淋巴细胞(sTIL)水平升高与治疗结果和预后相关。本研究旨在探讨TNBC的临床病理和超声特征与sTILs水平的关系。
方法:本研究包括侵袭性TNBC患者手术切除后对sTILs的术后评估。肿瘤形状,margin,定位,回声模式,后部特征,钙化,和血管分布进行回顾性评估。患者分为高sTIL(≥20%)和低sTIL(<20%)水平组。卡方或Fisher精确检验用于评估临床病理和超声特征与sTILs水平的关联。
结果:171例患者(平均±SD年龄,54.7±10.3年[范围,22-87年])包括低sTIL水平的58.5%(100/171)和高sTIL水平的41.5%(71/171)。高sTILs水平的TNBC肿瘤更有可能是非特殊类型的浸润性癌(p=0.008)。组织学分级较高(p=0.029),较高的Ki-67增殖率(均p<0.05),以及相关DCIS分量的较低频率(p=0.026)。此外,高sTIL水平的TNBC肿瘤更可能是椭圆形或圆形(p=0.001),平行取向(p=0.011),外接或微分叶边缘(p<0.001),复杂的囊性和实性回声模式(p=0.001),后增强(p=0.002),并且不太可能具有异质模式(p=0.001)并且没有后验特征(p=0.002)。
结论:这项初步研究表明,术前超声特征有助于区分TNBC患者的高sTILs和低sTILs。
BACKGROUND: Increased level of stromal tumor-infiltrating lymphocytes (sTILs) are associated with therapeutic outcomes and prognosis in triple-negative breast cancer (TNBC). This study aimed to investigate the associations of clinicopathologic and sonographic features with sTILs level in TNBC.
METHODS: This study included invasive TNBC patients with postoperative evaluation of sTILs after surgical resection. Tumor shape, margin, orientation, echo pattern, posterior features, calcification, and vascularity were retrospectively evaluated. The patients were categorized into high-sTILs (≥ 20%) and low-sTILs (< 20%) level groups. Chi-square or Fisher\'s exact tests were used to assess the association of clinicopathologic and sonographic features with sTILs level.
RESULTS: The 171 patients (mean ± SD age, 54.7 ± 10.3 years [range, 22‒87 years]) included 58.5% (100/171) with low-sTILs level and 41.5% (71/171) with high-sTILs level. The TNBC tumors with high-sTILs level were more likely to be no special type invasive carcinoma (p = 0.008), higher histologic grade (p = 0.029), higher Ki-67 proliferation rate (all p < 0.05), and lower frequency of associated DCIS component (p = 0.026). In addition, the TNBC tumors with high-sTILs level were more likely to be an oval or round shape (p = 0.001), parallel orientation (p = 0.011), circumscribed or micro-lobulated margins (p < 0.001), complex cystic and solid echo patterns (p = 0.001), posterior enhancement (p = 0.002), and less likely to have a heterogeneous pattern (p = 0.001) and no posterior features (p = 0.002).
CONCLUSIONS: This preliminary study showed that preoperative sonographic characteristics could be helpful in distinguishing high-sTILs from low-sTILs in TNBC patients.