三级淋巴结构异质性在三阴性乳腺癌新辅助治疗中的预测作用及免疫微环境特征的研究现状与展望

王青; 俞育帅; 王晨曦; 姜子荣; 李佳璐; 唐诗聪; 宋传贵

doi:10.19401/j.cnki.1007-3639.2025.02.008

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三级淋巴结构异质性在三阴性乳腺癌新辅助治疗中的预测作用及免疫微环境特征的研究现状与展望

专家述评 | 更新时间：2025-12-31

- 三级淋巴结构异质性在三阴性乳腺癌新辅助治疗中的预测作用及免疫微环境特征的研究现状与展望
- Current status and prospects of tertiary lymphoid structure heterogeneity in predicting response to neoadjuvant therapy and characterizing immune microenvironment in triple-negative breast cancer
- 中国癌症杂志 2025年35卷第2期页码：213-218
- 作者机构：
  
  1. 福建省肿瘤医院（福建医科大学肿瘤临床医学院），乳腺外科，福建福州 350014
  2. 云南省肿瘤医院（昆明医科大学第三附属医院），乳腺外科，云南昆明 650118
  3. 昆明医科大学，康复学院，云南昆明，650118
- 作者简介：
  
  [ "王青（ORCID: 0000-0001-9243-337X），博士研究生。" ]
  [ "宋传贵，博士，主任医师、教授、博士研究生导师，福建省肿瘤医院乳腺肿瘤学科带头人，福建省肿瘤医院乳腺肿瘤诊治中心执行主任。曾任美国得克萨斯大学安德森癌症中心高级访问学者。现任中国抗癌协会乳腺癌专业委员会常务委员、中国抗癌协会肿瘤靶向治疗专业委员会常务委员、福建省抗癌协会乳腺癌专业委员会主任委员、中国肿瘤学会乳腺癌专家委员会委员、中华医学会肿瘤分会乳腺学组成员。主持国家自然科学基金、福建省科技创新联合重大项目、福建省自然科学基金及卫健委重点人才等多项研究课题，在国际学术期刊上发表论文多篇；参编《乳腺肿瘤学》、《HER2阳性乳腺癌》及《精准时代的乳腺肿瘤学》等专著，参与多部临床指南的编写工作。担任Journal of Clinical Oncology中文版的编委、Cancer中国特刊编委。" ]
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2025.02.008
  中图分类号： R737.9
- 收稿：2024-11-13，
  
  修回：2025-01-22，
  
  纸质出版：2025-02-28
- 稿件说明：
移动端阅览
王青, 俞育帅, 王晨曦, 等. 三级淋巴结构异质性在三阴性乳腺癌新辅助治疗中的预测作用及免疫微环境特征的研究现状与展望[J]. 中国癌症杂志, 2025,35(2):213-218.

Qing WANG, Yushuai YU, Chenxi WANG, et al. Current status and prospects of tertiary lymphoid structure heterogeneity in predicting response to neoadjuvant therapy and characterizing immune microenvironment in triple-negative breast cancer[J]. China Oncology, 2025, 35(2): 213-218.
王青, 俞育帅, 王晨曦, 等. 三级淋巴结构异质性在三阴性乳腺癌新辅助治疗中的预测作用及免疫微环境特征的研究现状与展望[J]. 中国癌症杂志, 2025,35(2):213-218. DOI： 10.19401/j.cnki.1007-3639.2025.02.008.

Qing WANG, Yushuai YU, Chenxi WANG, et al. Current status and prospects of tertiary lymphoid structure heterogeneity in predicting response to neoadjuvant therapy and characterizing immune microenvironment in triple-negative breast cancer[J]. China Oncology, 2025, 35(2): 213-218. DOI： 10.19401/j.cnki.1007-3639.2025.02.008.

摘要

三阴性乳腺癌（triple-negative breast cancer，TNBC）是一种高度侵袭性且预后不良的乳腺癌亚型，三级淋巴结构（tertiary lymphoid structure，TLS）是肿瘤微环境中的免疫活性区域，由树突状细胞、B细胞、T细胞等免疫细胞组成，能够调节肿瘤免疫反应。TLS在TNBC中的异质性特征，如密度、结构成熟度和分子表达模式，影响着肿瘤免疫微环境，进而影响治疗反应和临床表现。研究表明，TLS的密度和成熟度与TNBC患者的病理学完全缓解（pathological complete response，pCR）呈正相关，TLS通过增强肿瘤浸润免疫细胞的数量，改善抗肿瘤免疫反应，增加TNBC对化疗和免疫治疗的敏感性。最新研究发现，成熟的TLS与有效的免疫反应相关，成为预测治疗反应的重要标志物。将TLS与免疫检查点抑制剂联合应用，展现出良好的治疗前景。此外，有研究表明，促进TLS的形成或增强其功能，可以提高抗肿瘤免疫效应，改善TNBC患者的治疗效果。通过靶向TLS，能够减少免疫逃逸，提高免疫治疗的敏感性。然而，TLS在临床应用中仍面临挑战，尤其是其异质性对治疗反应的影响。TLS的评估方法尚未标准化，缺乏统一的标准和诊断体系，限制了其广泛应用。未来的研究应着重解决这些问题，开发标准化评估工具，并进一步探讨TLS在免疫逃逸、免疫耐药机制中的作用。本综述总结和分析TLS在TNBC中的研究进展，旨在为确立TNBC患者个体化免疫治疗策略提供新的思路。

Abstract

Triple-negative breast cancer (TNBC) is a highly aggressive and prognostically unfavorable subtype. Tertiary lymphoid structure (TLS) within the tumor microenvironment

comprising dendritic cells

B cells

T cells

and other immune cells

modulate the tumor immune response. The heterogeneity of TLS in TNBC

such as density

structural maturity

and molecular expression patterns

affects the tumor immune microenvironment and

consequently

treatment responses and clinical outcomes. Studies indicate a positive correlation between the density and maturity of TLS and the pathological complete response (pCR) of TNBC patients

with TLS enhancing the quantity of tumor-infiltrating immune cells and improving anti-tumor immune responses

thereby increasing sensitivity to chemotherapy and immunotherapy. Recent research has found that mature TLS are associated with effective immune responses

becoming significant predictors of treatment response. The combination of TLS with immune checkpoint inhibitors has shown promising prospects. Research demonstrates that promoting the formation or enhancing the functionality of TLS can improve anti-tumor immune effects and enhance treatment outcomes for TNBC patients. Targeting TLS may reduce immune evasion and increase the sensitivity to immunotherapy. However

clinical application of TLS still faces challenges

particularly the impact of their heterogeneity on treatment response. Current assessment methods for TLS are not standardized

lacking a uniform standard and diagnostic system

which limits their widespread application. Future research should focus on resolving these issues by developing standardized assessment tools and further exploring the role of TLS in immune escape and resistance mechanisms. This review aimed to summarize and analyze the existing research progress on TLS in TNBC

in order to provide new ideas for the development of personalized immunotherapy strategies.

关键词

Keywords

references

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