Abstract: Objective To evaluate the infiltration level of tumor infiltrating lymphocytes （TILs） and explore the correlation between TILs and the efficacy of neoadjuvant chemotherapy for breast cancer. Methods A total of 87 cases were included with invasive breast cancer were diagnosed by preoperative biopsy. TILs infiltration evaluated by H＆E staining under microscope. The correlation between the expression levels of TILs and clinicopathological features as well as the efficacy of neoadjuvant chemotherapy was analyzed. Results The expressions of TILs in the preoperative core needle biopsy were closely related to the molecular subtypes of breast cancer, and the expression was highest in the HER2 over-expression and triple negative breast cancer subtypes. TILs level was significantly correlated with the expression of ER, PR and pathological complete response（pCR）. TILs level was higher in ER-and PR- patients （P<0.05）. The pCR rate in patients with high TILs infiltration was significantly higher than that in low TILs infiltration （P<0.05）. The pCR rates were also higher in ER- and PR- patients （P<0.05）. Multivariate analysis showed that TILs was an independent predictor for efficacy of neoadjuvant chemotherapy （P=0.041）. Conclusion Our study found that TILs was an independent predictor of the efficacy of neoadjuvant chemotherapy. A high TILs lever indicates better therapeutic effect.

Key words: breast cancer, neoadjuvant chemotherapy, tumor infiltrating lymphocytes

摘要： 目的 利用苏木素和伊红（H＆E）染色评估肿瘤浸润淋巴细胞（TILs）浸润水平,探索TILs与乳腺癌新辅助化疗（NAC）疗效的相关性。方法 收集87例乳腺浸润性导管癌术前经空芯针穿刺获得的组织样本,对组织样本行H＆E染色,显微镜下评估H＆E切片的TILs浸润情况,分析TILs水平与各临床病理特征的相关性及与新辅助化疗疗效的相关性。结果 新辅助化疗前经空芯针穿刺标本中的TILs水平与乳腺癌分子分型密切相关,在HER2过表达及TNBC亚型中表达最高,TILs与激素受体ER、PR表达及NAC后病理完全缓解（pCR）显著相关,ER-、PR-患者中TILs水平更高（P<0.05）,高TILs浸润患者NAC后pCR率显著高于低TILs浸润患者（P<0.05）,同时,ER-、PR-患者pCR率更高（P<0.05）,logistic回归分析显示TILs是新辅助化疗疗效的独立预测因素（P=0.048）。结论 TILs是新辅助化疗疗效的独立预测因子,高TILs表达预示着新辅助化疗疗效更好,更容易达到pCR。

关键词: 乳腺癌, 新辅助化疗, 肿瘤浸润淋巴细胞