The Predictive Value Of Tils For Trastuzumab In Her-2 Positive Breast Cancer

Background and Objective:Breast cancer is the most popular malignant tumor for women in China,approximately 15% to 23% of breast cancer patients with overexpression of human epidermal growth factor receptor-2(Her-2).The patients with Her-2 overexpression seems to have more poor prognosis.Trastuzumab is a specific targeted drug for Her-2 positive breast cancer.Alarge number of studies have shown that trastuzumab combined with chemotherapy can effectively reduce the recurrence rate and metastatic rate for Her-2 positive breast cancer.Tumor infiltrating lymphocytes(Tils),one of the cell of the immune system,participate in killing tumor cells and controlling tumor growth.In recent years,some studies show that immune cells can improve the efficacy of chemotherapeutic drugs.Meanwhile,some studies have shown that Tils can improve the efficacy of trastuzumab in Her-2 positive breast cancer patients.The purpose of this study is to investigate the relationship between targeted therapy sensitivity and Tils subsets in Her-2 positive breast cancer patients,and to improve the efficacy of comprehensive treatment of Her-2 positive breast cancer patients.Method:A number of 236 cases of Her-2 positive breast cancerpatients who underwent modified radical mastectomy between May 2009 and November 2014 in the Affiliated Hospital of Qingdao University were collected.According to Denkert’s standards,all cases were divided into 3 groups based on the level of tumor infiltrating lymphocytes.The spss24.0 software package was used for statistical analysis,and the frequency and composition ratios were used to describe the distribution of the classification data.The chisquare test or Fisher’s exact test was used to compare the differences between the data sets;the Kplan-Meier method was used for survival analysis and the survival was plotted.For the curve,single factor cox regression analysis was used for univariate analysis,and multi-factor cox regression analysis was used to explore independent influencing factors affecting prognosis.All the tests in this paper were two-sided tests.The results were statistically significant at P<0.05.Results :The level of Tils is related to the violation of the right and left side of the breast,and the difference is statistically significant(P<0.05).The use of trastuzumab,the location of tumor,clinical stage and other indicators have nothing to do,the difference was not statistically significant(P> 0.05).Univariate analysis of the factors affecting OS and DFS in Her-2 positive breast cancer patients: The level of Tils infiltration is a protective factor for OS.With increasing levels of Tils infiltration,the risk of death decreases,with HR=0.252(0.1-0.637).<0.05.At the same time,the level of Tils infiltration is also a protective factor of DFS.With the increase of Tils infiltration,the risk of recurrence is decreased.HR=0.354(0.153-0.818),P<0.05.Multivariate analysis of the influencing factors of OS and DFS in Her-2 positive breast cancer patients: The statistical significance(P<0.05)of the above univariate analysis was factored into the multivariate analysis.It was found that the Tils groups was OS The protective factors,with the increase of Tils infiltration,the risk of death of patients decreased,HR = 0.273(0.106-0.703),P <0.05.At the same time,the level of Tils infiltration was also a protective factor of DFS.With the increase of Tils infiltration,the risk of recurrence was decreased.HR=0.408(0.175-0.948),P<0.05.Tils infiltration is an independent factor affecting Her-2 positive breast cancer.The difference in the prognosis of different Tils groupings was statistically significant.It was not related to the use of trastuzumab.The difference was not statistically significant.In the trastuzumab-treated group,Tils can increase the OS and DFS in the high-expression group of patients with Her-2 positive breast cancer.Conclusion:In patients with Her-2 positive breast cancer,the higher the level of infiltration of Tils,the better the prognosis.Tils is a protective factor for OS and DFS in Her-2 positive breast cancer patients,and it is an independent influencing factor for Her-2 positive breast cancer patients.In the trastuzumab-treated group,Tils can increase the OS and DFS in the highexpression group of patients with Her-2 positive breast cancer.