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中国癌症防治杂志

中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (4): 440-445.doi: 10.3969/j.issn.1674-5671.2025.04.07

• 论著 • 上一篇    下一篇

育龄期女性HER2低表达乳腺癌三级淋巴结构的临床病理意义

  

  1. 广西医科大学附属肿瘤医院病理科；广西医科大学附属肿瘤医院伦理委员会办公室
  • 出版日期:2025-08-25 发布日期:2025-09-12
  • 通讯作者: 曾丽霞 E?mail：1622653185@qq.com
  • 基金资助:
    广西壮族自治区科技厅项目（2025GXNSFAA069120）;广西壮族自治区卫生健康委员会西医类别自筹经费科研课题项目（Z?A2024712;Z?A20220742）

Clinicopathological implications of tertiary lymphoid structures in HER2⁃low breast cancer in women of reproductive age

  • Online:2025-08-25 Published:2025-09-12

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摘要： 目的 探讨育龄期女性人表皮生长因子受体⁃2（human epidermal growth factor receptor 2,HER2）低表达乳腺癌中的三级淋巴结构（tertiary lymphoid structures,TLSs）与临床病理学参数、生物标志物及预后的相关性。方法 收集广西医科大学附属肿瘤医院2019年1月至2022年12月HER2低表达乳腺癌且年龄在15~49岁女性患者的临床及预后资料，使用全视野数字切片图像评估HER2低表达乳腺癌中TLSs是否存在及其成熟状态，并分析其与无病生存期（disease⁃free survival, DFS）的关联。结果 共225例患者纳入分析，中位年龄44岁（范围：28~49岁）。其中36.0%（81/225）的患者有TLSs，TLSs(+)及成熟度与肿瘤的组织学级别、伴有导管原位癌、雌激素受体、孕激素受体、Ki⁃67的表达及分子分型相关（均P<0.05）。多因素Cox回归分析表明，TLSs(+)状态及其成熟度是DFS不良的独立预测因素（均P<0.05）。结论 TLSs的存在及其成熟度与育龄期女性HER2低表达乳腺癌患者的不良预后独立相关，提示TLSs可能为潜在的预后生物标志物及免疫治疗靶点。

关键词: 乳腺癌, 三级淋巴结构, 人表皮生长因子受体?2, 育龄期, 肿瘤免疫微环境

Abstract: Objective To investigate the association between tertiary lymphoid structures (TLSs) and clinicopathological parameters， biomarkers， and prognosis in human epidermal growth factor receptor 2 (HER2)⁃low breast cancer among women of reproductive age. Methods Clinical and prognostic data were collected from female patients with HER2⁃low breast cancer， aged 15 to 49 years， treated at Guangxi Medical University Cancer Hospital between January 2019 and December 2022. Whole slide image (WSI) analysis was performed to evaluate the presence and maturity of TLSs in HER2⁃low breast cancer， and their correlation with disease⁃free survival (DFS) was analyzed. Results The analysis included 225 patients， with a median age of 44 years (range: 28-49 years)， and TLSs were detected in 36.0% (81/225) of cases. The presence and maturity of TLSs were significantly associated with tumor histological grade， associated ductal carcinoma in situ (DCIS)， expression of estrogen receptor (ER) ， progesterone receptor (PR) ， Ki⁃67 and molecular subtypes (all P<0.05). Multivariate Cox regression analyses indicated that the presence and maturity of TLSs were independent predictors of decreased DFS (all P<0.05). Conclusions The presence and maturity of TLSs are independently associated with poor prognosis in reproductive⁃aged women diagnosed with HER2⁃low breast cancer. This suggest that TLSs may hold potential as prognostic biomarkers and targets for immunotherapy.

Key words: Breast cancer, Tertiary lymphoid structures, Human epidermal growth factor receptor 2, Reproductive age, Tumor immune microenvironment

中图分类号: 

  • R737.9