Obeagu Emmanuel Ifeanyi, Obeagu Getrude Uzoma
Department of Medical Laboratory Science, Kampala International University, Ishaka, Uganda.
School of Nursing Science, Kampala International University, Ishaka, Uganda.
Medicine (Baltimore). 2024 Dec 6;103(49):e40845. doi: 10.1097/MD.0000000000040845.
Breast cancer is a leading cause of cancer-related mortality among women worldwide, necessitating the identification of reliable prognostic markers to guide treatment and improve patient outcomes. Recent research has highlighted the prognostic significance of tumor-infiltrating lymphocytes (TILs) in breast cancer, with high levels of TILs being associated with improved survival rates and better responses to therapy. This review delves into the mechanisms driving lymphocyte infiltration, its clinical implications, and the potential for TILs to serve as predictive biomarkers in breast cancer management. The presence of TILs within the tumor microenvironment reflects a dynamic interplay between tumor cells and the host immune system. Chemokine signaling, antigen presentation, and immune checkpoint interactions are key mechanisms that facilitate the recruitment and activity of lymphocytes at the tumor site. Clinically, the density of TILs varies across breast cancer subtypes, with the most significant prognostic value observed in triple-negative and HER2-positive breast cancers. High TIL levels correlate with improved overall survival and disease-free survival, underscoring their potential as a valuable prognostic indicator. Therapeutically, the role of TILs has opened new avenues in breast cancer treatment, particularly in the realm of immunotherapy. Immune checkpoint inhibitors, adoptive cell therapy, and combination therapies leveraging TILs are being explored to enhance antitumor responses. As research progresses, the integration of TIL assessment into routine clinical practice could revolutionize personalized treatment strategies, ultimately improving prognostic accuracy and patient outcomes in breast cancer care.
乳腺癌是全球女性癌症相关死亡的主要原因,因此需要确定可靠的预后标志物来指导治疗并改善患者预后。最近的研究强调了肿瘤浸润淋巴细胞(TILs)在乳腺癌中的预后意义,高水平的TILs与生存率提高和对治疗的更好反应相关。本综述深入探讨了驱动淋巴细胞浸润的机制、其临床意义以及TILs在乳腺癌管理中作为预测生物标志物的潜力。肿瘤微环境中TILs的存在反映了肿瘤细胞与宿主免疫系统之间的动态相互作用。趋化因子信号传导、抗原呈递和免疫检查点相互作用是促进淋巴细胞在肿瘤部位募集和活性的关键机制。在临床上,TILs的密度在不同乳腺癌亚型中有所不同,在三阴性和HER2阳性乳腺癌中观察到最显著的预后价值。高TIL水平与总体生存率和无病生存率的提高相关,突出了它们作为有价值的预后指标的潜力。在治疗方面,TILs的作用为乳腺癌治疗开辟了新途径,特别是在免疫治疗领域。正在探索免疫检查点抑制剂、过继性细胞疗法以及利用TILs的联合疗法以增强抗肿瘤反应。随着研究的进展,将TIL评估纳入常规临床实践可能会彻底改变个性化治疗策略,最终提高乳腺癌护理中的预后准确性和患者预后。