目的:三阴性乳腺癌(TNBC)作为侵袭性肿瘤提出了临床挑战,与不良预后相关。肿瘤浸润淋巴细胞(TIL)作为潜在的预后生物标志物引起了人们的兴趣。然而,不同TILs率之间的结果差异仍未得到充分探讨.
方法:PubMed,Scopus,WebofScience,在Cochrane数据库中搜索有关TILs在接受新辅助化疗的TNBC患者中的预后价值的研究。计算二元终点的风险比(HR)或比值比(OR),95%置信区间(CI)。
结果:纳入了29项研究,涉及六千一百六十一(80.41%)的TNBC人口。截止TILs值范围为10%至60%,50%是最相关的值。与低TIL表达组相比,无病生存期(DFS)(HR0.71;95%CI0.61-0.82;p<0.00001)和总生存期(OS)(HR0.76;95%CI0.63-0.90;p=0.002)显示出较高的TIL浸润率显著改善.在淋巴细胞亚型CD4+和CD8+的亚组分析中,这两种亚型的TILs率均有统计学意义,每个与改善的DFS(HR0.48;95%CI0.33-0.71;p=0.0002)和OS(HR0.53;95%CI0.36-0.78;p=0.001)相关,无论哪个细胞亚型主要浸润。完整的病理反应分析显示,在TIL(OR1.29;95%CI1.13-1.48;p=0.0003)和Ki-67(OR2.74;95%CI2.01-3.73;p<0.00001)分析中,高TIL组比对照组高。
结论:TILs在TNBC患者中的高表达与DFS显著改善相关,操作系统,和pCR结果。
OBJECTIVE: Triple-negative breast cancer (TNBC) presents a clinical challenge as an aggressive tumor, correlated with unfavorable prognosis. Tumor-infiltrating lymphocytes (TILs) have garnered interest as a potential prognostic biomarker. However, the disparity in outcomes between varying TILs rates remains inadequately explored.
METHODS: PubMed, Scopus, Web of Science, and Cochrane databases were searched for studies about the prognostic value of TILs in patients with TNBC receiving neoadjuvant chemotherapy. The hazard ratios (HRs) or odds ratios (ORs) were computed for binary endpoints, with 95% confidence intervals (CIs).
RESULTS: Twenty-nine studies were included, involving a population of six thousand one hundred sixty-one (80.41%) with TNBC. The cut-off TILs value ranged from 10 to 60%, with 50% being the most related value. Compared with the low-TIL expression group, the disease-free survival (DFS) (HR 0.71; 95% CI 0.61-0.82; p < 0.00001) and overall survival (OS) (HR 0.76; 95% CI 0.63-0.90; p = 0.002) rates showed significant improvement with higher TIL infiltrations. In the subgroup analyses of the lymphocyte subtypes CD4 + and CD8 + , there was statistical significance favoring higher TILs rates in both subtypes, each associated with improved DFS (HR 0.48; 95% CI 0.33-0.71; p = 0.0002) and OS (HR 0.53; 95% CI 0.36-0.78; p = 0.001), regardless of which cell subtype was predominantly infiltrated. The complete pathological response analysis showed better rates for the higher TIL group than the control for both the TIL (OR 1.29; 95% CI 1.13-1.48; p = 0.0003) and Ki-67 (OR 2.74; 95% CI 2.01-3.73; p < 0.00001) analyses.
CONCLUSIONS: Higher expressions of TILs in patients with TNBC were associated with improved significantly DFS, OS, and pCR outcomes.