免疫透,效应T细胞丰富和功能背景,用于预测乳腺癌中对新辅助化疗的病理完整反应
Ana Demšar1,2, Klara Geršak3,4,5, Barbara Gazić4,6
1Faculty of Medicine, University of Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia.
International journal of molecular sciences
|March 14, 2026
概括
瘤透淋巴细胞 (TIL) 预测乳腺癌中新辅助化疗 (NACT) 的反应. 将TIL与CD8和免疫检查点集成提供了洞察力,但TIL仍然是预测病理完整反应 (pCR) 最可靠的生物标志物.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 生物标志物发现发现
背景情况:
- 瘤透淋巴细胞 (TIL) 是接受新辅助化疗 (NACT) 的乳腺癌患者病理完整反应 (pCR) 的确立预测剂.
- TILs主要表明免疫细胞透程度,为免疫系统的功能状态提供有限的洞察力.
- 通过整合免疫透,效应T细胞存在和免疫检查点标记物,可以潜在地增强PCR的预测模型.
研究的目的:
- 调查结合TILs,CD8 T细胞存在和免疫检查点标记物 (PD-1,LAG-3,TIM-3) 是否可以改善早期乳腺癌中NACT后的PCR预测.
- 探索反映功能性免疫状态的复合免疫表型及其与pCR的关联.
- 为了评估这些免疫标记物的附加值超出TIL评估单独预测治疗反应.
主要方法:
- 对166名乳腺癌早期患者接受标准NACT的治疗前瘤活检的分析.
- 基层TILs和CD8,PD-1,LAG-3和TIM-3的mRNA表达量的量化.
- 单变量和多变量逻辑回归,以及等级建模来评估与pCR和模型歧视 (AUC) 的关联.
主要成果:
- 在单变量分析中,较高的TIL,CD8,PD-1和LAG-3与pCR相关;TIM-3没有显著意义.
- 在多变量模型中,TILs仍然与pCR相关,但由于CD8的纳入,这种影响减弱了. CD8和检查点标记没有保持独立的意义.
- 复合免疫表型,特别是CD8高/PD-1高,显示了最高的pCR率. 综合性CD8/PD-1模型实现了0.849的AUC,比单独的TILs略有改善.
结论:
- 免疫透 (TIL),效应T细胞存在 (CD8) 和功能背景 (免疫检查点) 为乳腺癌NACT中的PCR预测提供了补充信息.
- 免疫检查点表达 (PD-1,LAG-3) 与CD8和TIL相关,反映了参与的免疫微环境.
- 虽然整合免疫标志物提供了适度的预测收益,但TIL仍然是pCR预测中最强大的和临床上最实用的生物标志物.
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