摘要
目的探讨肿瘤间质比(tumor-stroma ratio,TSR)和肿瘤浸润淋巴细胞(tumor-infiltrating lymphocytes,TIL)对淋巴结阳性非特殊型浸润性乳腺癌预后的影响。方法采用HE染色法评估260例乳腺原发癌和相应淋巴结转移癌中TSR和原发癌中的TIL对患者预后的影响。结果乳腺原发癌中TSR≥50%(低间质组)148例,TSR<50%(高间质组)112例,低间质组患者总生存率和无瘤生存率明显高于高间质组(P均<0.05);TIL低表达组(TIL<10%)155例,高表达组(TIL≥10%)105例,两组患者总生存率和无瘤生存率差异无统计学意义(P均>0.05)。淋巴结转移癌中TSR≥50%(低间质组)163例,TSR<50%(高间质组)97例,低间质组患者无瘤生存率明显高于高间质组(P<0.05);原发癌和淋巴结转移癌同为低间质组时,原发癌低间质组提示预后更好(P<0.05)。原发癌与淋巴结转移癌中TSR呈明显的正相关(r=0.726,P<0.01)。原发癌低间质组中TIL的表达对预后影响,差异无统计学意义(P均>0.05);高间质组中TIL高表达组无瘤生存率明显高于TIL低表达组(P=0.012)。患者总生存率和无瘤生存率与年龄、肿块直径、组织学分级和阳性淋巴结个数无关(P均>0.05)。结论TSR是判断淋巴结转移的乳腺癌患者预后重要指标,且在原发癌和转移癌之间呈正相关,但原发癌TSR对判断预后更有意义。联合TSR和TIL分析,可为淋巴结阳性的乳腺癌患者预后和临床治疗提供帮助。
Purpose To investigate the effect of tumor-stroma ratio(TSR)and tumor-infiltrating lymphocytes(TIL)on the prognosis of invasive breast carcinoma of no special type with lymph node metastasis.Methods Hematoxylin-eosin staining was used to evaluate the prognostic effects of TSR and TIL in 260 cases of primary breast cancer and corresponding lymph node metastatic carcinoma.Results There were 148 patients with TSR≥50%(stroma-low group)and 112 patients with TSR<50%(stroma-high group)in primary cancer,the overall survival rates and tumor-free survival rates in the stroma-low group were significantly higher than those in the stroma-high group(P<0.05,respectively).There were 155 patients in the low TIL group(TIL<10%),and 105 patients in the high TIL group(TIL≥10%),there was no significant difference in the overall survival rates and tumor-free survival rates between the two groups(P>0.05,respectively).Among patients with lymph node metastases,163 patients with TSR≥50%(stroma-low group)and 97 patients with TSR<50%(stroma-high group),the tumor-free survival rates in the stroma-low group was significantly higher than that of stroma-high group(P<0.05).When the primary cancer and lymph node metastases were in the stroma-low group,the stroma-low group of primary cancer showed a better prognosis(P<0.05).There was a significant positive correlation between TSR in primary cancer and lymph node metastasis(r=0.726,P<0.01).The expression of TIL in the stroma-low group of primary cancer showed no statistical significance for the prognosis(P>0.05,respectively).The tumor-free survival rates of the high TIL group was significantly higher than that of the low TIL group in the stroma-high group(P=0.012).Overall survival rates and tumor-free survival rateswere not correlated with patient age,tumor size,histological grade and number of positive lymph nodes(P>0.05,respectively).Conclusion TSR is an important indicator for the prognosis of breast cancer patients with lymph node metastasis,and there is a positive correlation between primary cancer and metastatic cancer,but TSR of primary cancer is more significant for the prognosis.The combined analysis of TSR and TIL can help predict the prognosis of breast cancer patients with lymph node metastasis and guide clinical treatment.
作者
安杰
曾令瑞
宋婷婷
孙力伟
韩玉贞
AN Jie;ZENG Ling-rui;SONG Ting-ting;SUN Li-wei;HAN Yu-zhen(Department of Pathology,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,China;School of Public Health and Management,Binzhou Medical University,Yantai 264003,China)
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2020年第3期285-290,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
山东省自然科学基金(ZR2010HM096)。
关键词
乳腺肿瘤
肿瘤间质比
肿瘤浸润淋巴细胞
淋巴结转移
预后
breast neoplasm
tumor-stroma ratio
tumor-infiltrating lymphocytes
lymph node metastasis
prognosis
