Systematic evaluation of the relationship between tumor-infiltrating lymphocytes and prognosis of triple negative breast cancer / 国际外科学杂志

ABSTRACT

Objective:To investigate the prognostic value of tumor infiltrating lymphocytes (TILs) and their phenotypes, CD4 + TILs, CD8 + TILs and FOXP3 + TILs, in short-term prognosis (PCR) and long-term prognosis (DFS, OS) of triple negative breast cancer (TNBC), and to provide theoretical support for the immunotherapy of TNBC. Methods:A systematic surch of PubMed, Medline, Embase, Web of Science, CBM, CNKI was conducted to identified eligible articles. All prospective trials and observational controlled trials published before August 2020 were retrieved.The two authors independently evaluated the quality of the included literature, extracted the data, and conducted systematic evaluation and analysis using RevMan5.3 software.Results:A total of 48 literatures were included.Every 10% increase in TILs and TILs expression in the high-expression group predicted a higher PCR, OR were 1.81 (95% CI 1.44-2.28) and 1.09 (95% CI 1.02-1.15). For longer survival, the HR for DFS and OS were 0.99 (95% CI 0.98-0.99) and 0.90 (95% CI 0.86-0.94), 0.87 (95% CI 0.79-0.96) and 0.88 (95% CI 0.83-0.92). Phenotypic CD4 + TILs, CD8 + TILs, and FOXP3 + TILs did not show statistically significant differences in PCR among patients, but in long-term prognosis, higher infiltration predicted longer survival, with HR for DFS of 0.54 (95% CI 0.36-0.80), 0.46(95% CI 0.33-0.64) and 0.45(95% CI 0.31-0.68). HR of OS were 0.49 (95% CI 0.32-0.76), 0.59 (95% CI 0.54-0.66) and 0.44 (95% CI 0.27-0.71). Conclusion:The infiltration degree of TILs and the increase of TILs expression by 10% can be used as a prognostic index of TNBC.High levels of phenotypic infiltration of CD4 + TILs, CD8 + TILs, and FOXP3 + TILs predicted better long-term survival, but there was no statistically significant difference in short-term survival.