Abstract: Objective Our study was designed to investigate the predictive value of lymphocyte subsets before treatment for the efficacy of neoadjuvant chemotherapy （NAC） in breast cancer. Methods A total of 109 breast cancer patients received NAC in Sun Yat-sen Memorial Hospital, Sun Yat-sen University from April 2016 to June 2020 were enrolled in this study. Chi-square test and logistics regression were used to analyze the correlation between the proportion of different lymphocyte subsets and pathological complete response （pCR）, and Kaplan-Meier curve was used to evaluate the correlation between the lymphocyte subsets and survival time. At the same time, the relationship between the changes of T cells or NK cells before and after chemotherapy and pCR was evaluated, and the infiltration of T cells and NK cells in tumor sites was detected by immunohistochemical method. Results Patients with T cells proportion >71.90% （P=0.044）, NK cells proportion >36.23% （P=0.049） or Ki67 proliferation index >62.5% （P=0.010） showed a higher pCR rate. However, only high NK cells proportion （95% CI： 0.014-0.736, P=0.024） and high Ki67 proliferation index （95% CI： 0.083~0.752, P=0.014） was predictive for pCR in multivariate analysis. Comparing the changes of NK cells before and after NAC in 83 patients, patients with increased NK cells were found more likely to obtain pCR （P=0.031）. In addition, patients with a higher T cells proportion showed more tumor-infiltrating T cells before treatment, and patients with a higher NK cells proportion showed more tumor-infiltrating NK cells after NAC. Conclusion Higher proportion of T cells or NK cells may indicate a better pathological therapeutic efficacy. In addition, the proportion of peripheral T cells and NK cells may also be related to the tumor-infiltrating T cells and NK cells.

Key words: breast cancer, T cell, NK cell, neoadjuvant chemotherapy, pathologic complete response

摘要： 目的 本研究旨在探讨治疗前淋巴细胞亚群对乳腺癌新辅助化疗（NAC）疗效的预测价值。方法 本研究选取2016年4月至2020年6月在中山大学孙逸仙纪念医院接受NAC的乳腺癌患者109例。采用卡方检验及logistics回归分析不同淋巴细胞亚群比例与病理完全缓解（pCR）的相关性,并通过Kaplan-Meier曲线评估其与生存时间之间的相关性。同时评估化疗前后T细胞或NK细胞的变化与pCR的关系,并采用免疫组化法检测肿瘤部位T细胞和NK细胞的浸润情况。结果 T细胞比例>71.90%（P=0.044）、NK细胞比例>36.23%（P=0.049）或Ki67增殖指数>62.5%（P=0.010）的患者pCR率较高。在多因素分析中,只有NK细胞比例高（95% CI：0.014~0.736,P=0.024）和Ki67增殖指数高（95% CI：0.083~0.752,P=0.014）才是pCR的预测因素。比较83例患者NAC前后NK细胞的变化,发现NK细胞增多的患者更有可能获得pCR（P=0.031）。此外,治疗前T细胞比例较高的患者,肿瘤浸润性T细胞较多;NK细胞比例较高的患者治疗后,肿瘤浸润性NK细胞较多。结论 NAC前较高比例的T细胞或NK细胞可能表明较好的病理治疗效果。此外,NAC前T细胞和NK细胞的比例也可能与肿瘤部位T细胞和NK细胞的浸润有关。

关键词: 乳腺癌, T细胞, NK细胞, 新辅助化疗, 病理完全缓解