本文由小咖机器人翻译整理

期刊来源：JAMA

原文链接：https://doi.org/10.1001/jama.2024.3056

摘要内容如下：

重要性

在未接受辅助或新辅助化疗的早期三阴性乳腺癌（TNBC）患者中，乳腺癌组织中肿瘤浸润性淋巴细胞（TIL）丰度与癌症复发和死亡的关系尚不清楚。

目的

研究乳腺癌组织中TIL丰度与接受局部区域治疗但未接受化疗的早期三阴性乳腺癌患者生存率的关系。

设计、设置和参与者

对来自北美（明尼苏达州罗切斯特；加拿大不列颠哥伦比亚省温哥华）、欧洲（法国巴黎、里昂和维勒瑞夫；荷兰阿姆斯特丹和鹿特丹；意大利的米兰、帕多瓦和热那亚；瑞典哥德堡）和亚洲（日本东京；韩国首尔），包括在1979年至2017年期间诊断为TNBC的1966名参与者（随访至2021年9月27日），这些参与者接受了手术治疗，包括或不包括放疗，但没有辅助或新辅助化疗。

曝光

来自切除的原发性肿瘤的乳腺组织中的TIL丰度。

主要成果和措施

主要结果是侵袭性无病生存率[IDFS]。次要结果是无复发生存率[RFS]、无远处复发生存率[远处RFS，DRFS]和总生存率。使用按参与中心分层的多变量Cox模型评估相关性。

结果

该研究纳入了1966例TNBC患者（中位年龄56岁[IQR，39-71]；55%为I期TNBC）。中位TIL水平为15%（IQR，5%-40%）。417例（21%）患者的TIL水平为50%或更高（中位年龄为41岁[IQR，36-63]），1300例（66%）患者的TIL水平低于30%（中位年龄为59岁[IQR，41-72]）。对于TIL水平为50%或更高的患者，I期TNBC的5年DRF为94%（95%CI，91%-96%），而对于TIL水平低于30%的患者，5年DRF为78%（95%CI，75%-80%）；TIL水平为50%或以上的患者的5年总生存率为95%（95%CI，92%-97%），而TIL水平低于30%的患者的5年总生存率为82%（95%CI，79%-84%）。在中位随访18年，校正年龄、肿瘤大小、淋巴结状态、组织学分级和接受放疗后，TIL每增加10%，IDFs（风险比[HR]，0.92[0.89-0.94]）、RFS（HR，0.90[0.87-0.92]）、DRFS（HR，0.87[0.84-0.90]）、总生存率（0.88[0.85-0.91]）（似然比检验，P<10e-6）。

结论和相关性

在未接受辅助或新辅助化疗的早期TNBC患者中，TIL水平较高的乳腺癌组织与显著较好的生存率相关。这些结果表明，乳腺组织TIL丰度是早期TNBC患者的预后因素。

英文原文如下：

Abstracts

Importance  The association of tumor-infiltrating lymphocyte (TIL) abundance in breast cancer tissue with cancer recurrence and death in patients with early-stage triple-negative breast cancer (TNBC) who are not treated with adjuvant or neoadjuvant chemotherapy is unclear.

Objective  To study the association of TIL abundance in breast cancer tissue with survival among patients with early-stage TNBC who were treated with locoregional therapy but no chemotherapy.

Design, Setting, and Participants  Retrospective pooled analysis of individual patient-level data from 13 participating centers in North America (Rochester, Minnesota; Vancouver, British Columbia, Canada), Europe (Paris, Lyon, and Villejuif, France; Amsterdam and Rotterdam, the Netherlands; Milan, Padova, and Genova, Italy; Gothenburg, Sweden), and Asia (Tokyo, Japan; Seoul, Korea), including 1966 participants diagnosed with TNBC between 1979 and 2017 (with follow-up until September 27, 2021) who received treatment with surgery with or without radiotherapy but no adjuvant or neoadjuvant chemotherapy.

Exposure  TIL abundance in breast tissue from resected primary tumors.

Main Outcomes and Measures  The primary outcome was invasive disease-free survival [iDFS]. Secondary outcomes were recurrence-free survival [RFS], survival free of distant recurrence [distant RFS, DRFS], and overall survival. Associations were assessed using a multivariable Cox model stratified by participating center.

Results  This study included 1966 patients with TNBC (median age, 56 years [IQR, 39-71]; 55% had stage I TNBC). The median TIL level was 15% (IQR, 5%-40%). Four-hundred seventeen (21%) had a TIL level of 50% or more (median age, 41 years [IQR, 36-63]), and 1300 (66%) had a TIL level of less than 30% (median age, 59 years [IQR, 41-72]). Five-year DRFS for stage I TNBC was 94% (95% CI, 91%-96%) for patients with a TIL level of 50% or more, compared with 78% (95% CI, 75%-80%) for those with a TIL level of less than 30%; 5-year overall survival was 95% (95% CI, 92%-97%) for patients with a TIL level of 50% or more, compared with 82% (95% CI, 79%-84%) for those with a TIL level of less than 30%. At a median follow-up of 18 years, and after adjusting for age, tumor size, nodal status, histological grade, and receipt of radiotherapy, each 10% higher TIL increment was associated independently with improved iDFS (hazard ratio [HR], 0.92 [0.89-0.94]), RFS (HR, 0.90 [0.87-0.92]), DRFS (HR, 0.87 [0.84-0.90]), and overall survival (0.88 [0.85-0.91]) (likelihood ratio test, P < 10e-6).

Conclusions and Relevance  In patients with early-stage TNBC who did not undergo adjuvant or neoadjuvant chemotherapy, breast cancer tissue with a higher abundance of TIL levels was associated with significantly better survival. These results suggest that breast tissue TIL abundance is a prognostic factor for patients with early-stage TNBC.

-----------分割线---------

点击链接：https://www.mediecogroup.com/community/user/vip/categories/ ，成为医咖会员，获取12项专属权益。