伴微浸润的乳腺导管原位癌中肿瘤浸润淋巴细胞分布状态分析

目的 回顾性分析乳腺导管原位癌（DCIS）患者的临床病理资料,探讨伴微浸润的DCIS中肿瘤浸润淋巴细胞（TILs）的分布情况。方法 74例乳腺DCIS患者作为研究对象,不伴微浸润的DCIS（pure-DCIS）共42例作为对照组,伴微浸润的DCIS（mi-DCIS）32例作为实验组,分析其临床病理资料及TILs分布的差异,并进一步对mi-DCIS组原位癌及微浸润区域的TILs密度进行对比。结果 400倍高倍镜下,mi-DCIS组热点区域及平均值区域TILs百分比分别为57.50（18.75,80.00）%,8.00（5.00,15.00）%,pure-DCIS组分别为5.00（1.00,16.25）%,1.00（1.00,5.00）%,无论是热点区域还是平均值,mi-DCIS组TILs百分比均高于pure-DCIS组（P均< 0.001）。mi-DCIS组中微浸润灶处平均TILs比例为15.00 （5.00, 50.00）%,高于原位癌区域8.00（5.00,15.00）%,差异有统计学意义（P = 0.004）。结论 相较于pure-DCIS,mi-DCIS中TILs的分布密度明显增高;mi-DCIS中,微浸润灶处TILs的分布情况较整体有上升的趋势。

Analysis of distribution pattern of tumor-infitrating lymphoctyes in breast ductal carcinoma in situ complicated with microinfiltration

Objective To retrospectively review the clinocopathological data of patients with breast ductal carcinoma in situ （DCIS）, and explore the distribution pattern of tumor-infiltrating lymphocytes （TILs） in DCIS patients complicated with microinfiltration. Methods Seventy-four DCIS patients were recruited in this study. Among them, 42 patients with pure DCIS （pure-DCIS） were assigned into the control group, and 32 cases of DCIS complicated with microinfiltration （mi-DCIS） were allocated into the experimental group. The clinicopathological data and TILs distribution were analyzed. Moreover, the TILs density between the DCIS area and microinfiltration area were statistically compared in the mi-DCIS group. Results Under 400× microscope, the hot spot and average TILs percentages were 57.50（18.75, 80.00）% and 8.00（5.00, 15.00）% in the mi-DCIS group,and 1.00（1.00, 5.00）% and 5.00（1.00, 16.25）% in the pure-DCIS group, respectively. Regardless of the hot spot or average value, the TILs percentages in the mi-DCIS group were significantly higher than those in the pure-DCIS group （both P < 0.001）. In the mi-DCIS group, the average proportion of TILs in the micro-infiltrating lesions was 15.00（5.00, 50.00）%, significantly higher compared with 8.00（5.00, 15.00）% in the carcinoma in situ area （P = 0.004）. Conclusions Compared with pure-DCIS alone, the density of TILs distribution in mi-DCIS is significantly enhanced. In the mi-DCIS group, the distribution of TILs in the micro-infiltrating lesions tends to elevate compared with the overall distribution pattern.