The Meta-analysis Of The Relationship Between The Tumor Infiltrating Lymphocytes And The Curative Effect Of Neoadjuvant Chemotherapy In Breast Cancer

Objective: To evaluate the relationship between the tumor infiltrating lymphocytes and the curative effect of neoadjuvant chemotherapy in breast cancer by meta-analysis.Methods: The electronic databases including Pub Med, Web of Science, Embase, The Cochrane Library, Chinese Biomedical Literature Database, C hinese Scientific Journal Full-text Database and Wan Fang Database were systematically searched(up to Dec 2015). The main search terms used were ‘tumor infiltrating lymphocytes’, ‘breast cancer’, ‘neoadjuvant chemotherapy’, ‘pathlogical complete response’. The meta-analysis was performed using odds ratio(OR) and 95 % confidence intervals(CI) as effect measures. The relationship between the t umor infiltrating lymphocytes and the pathlogical complete response to neoadjuvant chemotherapy(N AC) in breast cancer was performed using Revman 5.3 and Stata 12.0.Results: Eight studies including 2590 patients with breast cancer were eligible. The meta-analysis indicated that the detection of higher levels of tumor infiltrating lymphocytes were correlated with better pathlogical complete response rates to neoadjuvant chemotherapy in breast cancer(OR=3.90, 95%CI:3.11-4.88). Moreover, tumor infiltrating lymphocytes predicted higher pathlogical complete response rates in triple negative breast cancer(OR=2.06, 95%CI:1.39-3.07), HR positive/HER-2 negative breast cancer(OR=4.13, 95%CI:1.79-9.49), HR negative/HER-2 positive breast cancer(OR=4.76, 95%CI:1.50-15.03), but not HR positive/HER2 positive breast cancer(OR=1.47, 95%CI:0.24-8.83).Conclusion: 1. The detection of higher levels of tumor infiltrating lymphocytes indicated higher pathlogical complete response rates for neoadjuvant chemotherapy in breast cancer, and the TILs can be used as a predictor of the recent curative effect for neoadjuvant chemotherapy in breast cancer.2. Subgroup analysis showed that the tumor infiltrating lymphocytes predicted higher pathlogical complete response rates in triple negative subtype, HR positive/HER-2 negative subtype, HR negative/HER-2 positive subtype, but not HR positive/HER-2 positive subtype. The number of the included studies in each subgroup was small, the results remained to be further confirmed.