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淋巴细胞相关炎性反应指标与乳腺癌预后的相关性

Prognostic Value of Lymphocyte-associated Inflammatory Markers in Breast Cancer

  • 摘要:
    目的 探讨治疗前中性粒细胞淋巴细胞比(NLR)、淋巴细胞单核细胞比(LMR)、血小板淋巴细胞比(PLR)与乳腺癌患者临床病理特征及预后的关系。
    方法 回顾性分析189例乳腺癌患者的临床资料,应用ROC曲线获得NLR、LMR、PLR的临界值。根据临界值将患者分为高低两组,分析NLR、LMR、PLR与临床病理特征及预后的相关性。
    结果 NLR、LMR、PLR最佳临界值分别为2.4、5.4、113。高低NLR组患者的新辅助化疗和手术治疗差异有统计学意义(均P < 0.05),高低LMR组和PLR组患者在各临床病理特征方面差异无统计学意义(均P > 0.05)。单因素分析结果显示,TNM临床分期、PR表达、NLR、LMR、PLR、手术以及内分泌治疗均与OS有关(均P < 0.05);TNM临床分期、HER2表达、NLR、手术以及内分泌治疗均与PFS有关(均P < 0.05)。多因素分析结果显示,TNM临床分期(P=0.003)和NLR(P=0.033)是OS的独立危险因素;TNM临床分期(P=0.002)和手术治疗(P=0.040)是PFS的独立影响因素。
    结论 治疗前NLR、LMR、PLR与乳腺癌的预后存在显著相关性,但仅NLR是独立危险因素,LMR、PLR尚不能作为独立预测因子。

     

    Abstract:
    Objective  To explore the correlation of pretreatment NLR, LMR and PLR with clinical characteristics and prognosis of breast cancer patients.
    Methods  We retrospectively analyzed the data of 189 patients with breast cancer. ROC curve was used to obtain the optimal cutoff values of NLR, LMR and PLR. The patients were divided into two groups according to the cutoff values, and the correlation between NLR, LMR, PLR and clinical characteristics and prognosis was analyzed.
    Results  The optimal cutoff values of NLR, LMR and PLR were 2.4, 5.4 and 113, respectively. There was statistical significant difference in neoadjuvant chemotherapy and surgery between the high and low levels of NLR groups (all P < 0.05). There was no statistical significant difference in clinical characteristics between the high and low levels of LMR groups, as well as the high and low levels of PLR groups (all P > 0.05). Univariate analysis showed that PR expression, TNM clinical stage, NLR, LMR, PLR, surgery and endocrinotherapy were related to OS (all P < 0.05); HER2 expression, TNM clinical stage, NLR, surgery and endocrinotherapy were associated with PFS (all P < 0.05). Multivariate analysis showed that TNM clinical stage (P=0.003) and NLR (P=0.033) were independent risk factors for OS; TNM clinical stage (P=0.002) and surgery (P=0.040) were independent prognostic factors for PFS.
    Conclusion  Pretreatment NLR, LMR and PLR are significantly correlated with the prognosis of breast cancer patients. Only NLR is an independent risk factor, however, LMR and PLR are not yet independent prognostic factors.

     

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