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中国癌症防治杂志

中国癌症防治杂志 ›› 2022, Vol. 14 ›› Issue (4): 424-.doi: 10.3969/j.issn.1674-5671.2022.04.11

• 临床研究 • 上一篇    下一篇

肿瘤浸润淋巴细胞在cT1N0M0期乳腺癌淋巴结转移中的预测价值

  

  1. 中国人民解放军联勤保障部队第910医院肿瘤科；甲乳外科
  • 出版日期:2022-08-25 发布日期:2022-09-08
  • 通讯作者: 张江灵 E-mail：zhangjiangling1212@163.com

Predictive value of tumor infiltrating lymphocyte in lymph node metastasis of cT1N0M0 breast cancer

  • Online:2022-08-25 Published:2022-09-08

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摘要：  目的 探讨cT1N0M0期乳腺癌患者肿瘤浸润淋巴细胞（tumor-infiltrating lymphocyte，TIL）与淋巴结转移的相关性， 以及TIL密度在预测患者前哨淋巴结转移 （sentinel lymph node metastasis，SLNM） 中的价值。方法 回顾性分析2008年1月至 2016年12月于本院接受手术治疗的cT1N0M0 期乳腺癌患者的临床资料。术前在活检标本中进行 TIL 密度的组织病理学评估。采用多因素logistic回归以及受试者工作特征（ROC）曲线分析TIL预测SLNM的价值。结果  共153例cT1N0M0期乳腺癌患者纳入分析， 其中30例（19.6%）患者发生SLNM。TIL密度与雌激素受体（ER）状态（P<0.001）、孕激素受体（PgR）状态（P=0.003）、人表皮生长因子受体2（HER2）状态（P=0.029）、Ki67表达（P=0.025）、核分级（P=0.026）相关。多因素logistic回归显示， TIL密度（OR=1.40，95%CI：1.15~1.71，P=0.001）是影响cT1N0M0期乳腺癌SLNM的独立因素， 其ROC曲线下面积（AUC）为0.755 （95%CI：0.680~0.830，P<0.001）。结论 TIL密度与cT1N0M0期乳腺癌SLNM密切相关， 可能是SLNM潜在的预测指标。

关键词: 乳腺癌, 淋巴结转移, 肿瘤浸润淋巴细胞, 预测价值

Abstract: Objective To investigate the correlation between tumor-infiltrating lymphocyte (TIL) and lymph node metastasis in patients with cT1N0M0 breast cancer and the value of TIL density in predicting sentinel lymph node metastasis (SLNM). Methods The clinical data of patients with cT1N0M0 breast cancer who underwent surgery in our hospital from January 2008 to December 2016 were retrospectively analyzed. The histopathological assessment of TIL density was performed in the biopsy specimens before surgery. The multivariable logistic regression and the receiver operating characteristic (ROC) curve were used to analyze the value of TIL in predicting SLNM. Results A total of 153 patients with cT1N0M0 stage breast cancer were included in the analysis, of which 30 patients (19.6%) developed SLNM. The TIL density was related to estrogen receptor (ER) status (P<0.001), progesterone receptor (PgR) status (P=0.003), human epidermal growth factor receptor 2 (HER2) status (P=0.029), Ki67 expression (P=0.025), and nuclear grade (P=0.026). Multivariable logistic regression showed that TIL density (OR=1.40, 95%CI: 1.15-1.71, P=0.001) was an independent factor affecting SLNM in cT1N0M0 breast cancer , and its area under the ROC curve (AUC) was 0.755 (95%CI: 0.680-0.830, P<0.001). Conclusions TIL density is closely related to SLNM in cT1N0M0 breast cancer and may be a potential predictor of SLNM.

Key words: Breast cancer, Lymph node metastasis, Tumor infiltrating lymphocyte, Predictive value

中图分类号: 

  • R737.9