| 梁洪陆,孟令军,张艳琦,等.肿瘤浸润淋巴细胞数量对 HER2阳性（激素受体阴性）型乳腺癌临床预后影响[J].肿瘤学杂志,2025,31(9):784-792. |
| 肿瘤浸润淋巴细胞数量对 HER2阳性（激素受体阴性）型乳腺癌临床预后影响 |
| Prognostic Impact of Tumor-Infiltrating Lymphocytes in HER2-Positive/Hormone Receptor-Negative Breast Cancer |
| 投稿时间：2024-09-11 |
| DOI：10.11735/j.issn.1671-170X.2025.09.B006 |
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| 中文关键词: 乳腺肿瘤 肿瘤浸润淋巴细胞 人表皮生长因子受体2 激素受体 曲妥珠单抗 |
| 英文关键词:breast neoplasms tumor infiltrating lymphocytes human epidermal growth factor receptor 2 hormone receptor trastuzumab |
| 基金项目:国家自然科学基金（32200855） |
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| 摘要点击次数: 155 |
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| 中文摘要: |
| 摘 要：［目的］ 探讨肿瘤浸润淋巴细胞（tumor infiltrating lymphocytes，TILs）在人表皮生长因子受体2（human epidermal growth factor receptor 2，HER2）阳性（激素受体阴性）型乳腺癌中的表达水平及其对预后的影响。［方法］ 收集2016年1月至2022年12月共164例女性HER2阳性（激素受体阴性）型乳腺癌病例资料。按照Denkert标准，根据HE染色切片结果分为瘤巢肿瘤浸润淋巴细胞（intratumora tumor infiltrating lymphocytes，ITILs）、间质肿瘤浸润淋巴细胞（stromal tumor infiltrating lymphocytes，STILs）两组，其中＞40%为高表达，≤40%为中低表达。收集病理报告中雌激素受体、孕激素受体、HER2和Ki-67表达情况。通过电话、查看病历等多种途径进行随访，随访截止至2023年12月31日。采用SPSS 22.0软件对患者资料进行分析，统计ITILs、STILs在 HER2阳性（激素受体阴性）型乳腺癌组织中的表达水平，探索TILs数量对预后的影响。［结果］ ITILs和STILs表达水平随着阳性淋巴结数增多而下降，差异具有统计学意义（ITILs组：?字2=6.806，P=0.033；STILs组：?字2=6.487，P=0.039）。ITILs、STILs 是 HER2阳性（激素受体阴性）型乳腺癌患者总生存期（overall survival，OS）和无病生存期（disease-free survival，DFS）的影响因素（DFS：ITILs：HR=0.094，P=0.007；STILs：HR=0.043，P=0.007。OS：ITILs：HR=0.097，P=0.039；STILs：HR=0.085，P=0.030）。ITILs、STILs表达水平是使用曲妥珠单抗组乳腺癌患者DFS（ITILs：?字2=5.715，P=0.017；STILs：?字2=5.990，P=0.014）和OS （ITILs：?字2=18.816，P=0.000；STILs：?字2=12.522，P＜0.001）的影响因素。ITILs、STILs表达水平是未使用曲妥珠单抗组乳腺癌患者DFS（ITILs：?字2=21.141，P=0.000；STILs：?字2=19.902，P=0.000）和OS （ITILs：?字2=13.377，P=0.000；STILs：?字2=16.449，P=0.000）的影响因素。［结论］ 在 HER2阳性（激素受体阴性）型乳腺癌患者中，ITILs、STILs表达水平越高，复发、转移及死亡风险越低，预后越好。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the expression levels of tumor-infiltrating lymphocytes (TILs) and their prognostic value in human epidermal growth factor receptor 2 (HER2)-positive/hormone receptor-negative breast cancer. ［Methods］ Clinical data of 164 female patients with HER2-positive/hormone receptor-negative breast cancer treated between January 2016 and December 2022 were retrospectively collected. Based on hematoxylin-eosin (HE) staining and the Denkert criteria， TILs were evaluated and categorized into intratumoral (ITILs) and stromal (STILs) compartments. A proportion of >40% was defined as high expression and ≤40% as low-to-intermediate expression. Expressions of estrogen receptor， progesterone receptor， HER2， and Ki-67 from pathological reports were collected. Follow-up was conducted via telephone and medical record review until December 31， 2023. Statistical analysis was performed using SPSS 22.0 software. The levels of ITILs and STILs were analyzed， and their influence on prognosis was assessed. ［Results］ The levels of ITILs and STILs were inversely correlated with the number of positive lymph nodes (ITILs： χ2=6.806， P=0.033； STILs： χ2=6.487， P=0.039). Both ITILs and STILs were identified as independent factors for disease-free survival (DFS) and overall survival (OS) (DFS： ITILs HR=0.094， P=0.007； STILs HR=0.043， P=0.007； OS： ITILs HR=0.097， P=0.039； STILs HR=0.085， P=0.030). In the subgroup of patients treated with trastuzumab， high expression of both ITILs and STILs was significantly associated with improved DFS(ITILs： χ2=5.715， P=0.017； STILs： χ2=5.990， P=0.014) and OS (ITILs： χ2=18.816， P=0.000； STILs： χ2=12.522， P<0.001). Similarly， in patients not undergoing trastuzumab， high ITILs and STILs expression were also significantly associated with DFS (ITILs： χ2=21.141， P=0.000； STILs： χ2=19.902， P=0.000) and OS (ITILs： χ2=13.377， P=0.000； STILs： χ2=16.449， P=0.000). ［Conclusion］ In patients with HER2-positive/hormone receptor-negative breast cancer， higher levels of ITILs and STILs are associated with lower risks of recurrence， metastasis， and death， indicating a better prognosis. |
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