| 王 慧,余嘉文,朱 晨,鲍亮亮,程 进,何宜生,操礼群.NLR、PLR、LMR与乳腺癌新辅助化疗疗效及预后的关系研究[J].,2023,(16):3118-3122 |
| NLR、PLR、LMR与乳腺癌新辅助化疗疗效及预后的关系研究 |
| Study of the Relationship between the NLR, PLR, LMR and the Efficacy and Prognosis of Neoadjuvant Chemotherapy of Breast Cancer |
| 投稿时间：2023-02-27 修订日期：2023-03-21 |
| DOI：10.13241/j.cnki.pmb.2023.16.023 |
| 中文关键词: 乳腺癌 新辅助化疗 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 淋巴细胞与单核细胞比值 病理疗效 预后 |
| 英文关键词: Breast cancer Neoadjuvant chemotherapy Neutrophil to lymphocyte ratio Platelet to lymphocyte ratio Lymphocyte to monocyte ratio Pathological efficacy Prognosis |
| 基金项目:安徽省卫生健康委科研项目（AHWJ2021a0314） |
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| 中文摘要: |
| 摘要 目的：探讨化疗前外周血中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）与乳腺癌患者新辅助化疗疗效及预后的关系。方法：选择2016年10月至2018年1月在安徽医科大学附属安庆第一人民医院进行新辅助化疗的乳腺癌患者105例为研究对象，根据新辅助化疗疗效分为病理完全缓解（pCR）组（26例）和非pCR组（79例）。比较pCR组和非pCR组化疗前外周血NLR、PLR、LMR；采用受试者工作特征（ROC）曲线分析化疗前外周血NLR、PLR、LMR对乳腺癌患者新辅助化疗病理疗效预测价值。所有患者术后随访5年，根据ROC曲线确定的NLR、PLR、LMR最佳截断值分为高NLR、PLR、LMR组和低NLR、PLR、LMR组，采用K-M生存曲线分析不同NLR、PLR、LMR组5年无病生存期（DFS）；单因素和多因素COX回归分析预后不良的影响因素。结果：pCR组化疗前NLR、PLR均低于非pCR组（P＜0.05），LMR高于非pCR组（P＜0.05）。化疗前NLR、PLR、LMR三项联合预测新辅助化疗病理疗效的曲线下面积（AUC）均大于各指标单独预测。K-M生存曲线分析显示，化疗前高NLR、PLR组5年DFS分别低于低NLR、PLR组（P＜0.05），高LMR组5年DFS高于低LMR组（P＜0.05）；多因素COX回归分析显示，NLR、PLR升高是乳腺癌预后的危险因素，LMR升高是保护因素（P<0.05）。结论：pCR组化疗前NLR、PLR更低，LMR更高，高NLR、PLR和低LMR患者5年DFS更低。NLR、PLR、LMR对新辅助化疗病理疗效具有一定的预测价值，三项联合能为乳腺癌的新辅助化疗评估提供重要参考依据。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the relationship between the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) in peripheral blood before chemotherapy and the efficacy and prognosis of neoadjuvant chemotherapy of patients with breast cancer. Methods: The 105 patients with breast cancer who were underwent surgery after neoadjuvant chemotherapy in Anqing First People's Hospital affiliated to Anhui Medical University from October 2016 to January 2018 were selected as the study subjects, and they were divided into pathological complete remission (pCR) group (26 cases) and non pCR group (79 cases) according to the efficacy of neoadjuvant chemotherapy. The NLR, PLR and LMR in peripheral blood before chemotherapy of pCR group and non pCR group were compared. The predictive value of NLR, PLR and LMR in peripheral blood before chemotherapy of patients with breast cancer for the pathological effect of neoadjuvant chemotherapy was analyzed by receiver operating characteristic (ROC) curve. All patients were followed up for 5 years after surgery, and divided into high NLR, PLR, LMR groups and low NLR, PLR, LMR groups based on the optimal cutoff values of NLR, PLR, and LMR determined by the ROC curve. The 5-year disease-free survival(DFS) time of NLR, PLR, and LMR groups at different levels were analyzed by K-M survival curve. Single factor and multivariate COX regression analysis of factors affecting poor prognosis. Results: The NLR and PLR before chemotherapy in the pCR group were lower than those in the non pCR group (P<0.05), while the LMR was higher than that in the non pCR group (P<0.05). The area under the curve (AUC) of the combined prediction of NLR, PLR, and LMR for the pathological efficacy of neoadjuvant chemotherapy before chemotherapy was greater than that predicted by each index alone. K-M survival curve analysis showed that the 5-year DFS of the high NLR and PLR groups before chemotherapy was lower than that of the low NLR and PLR groups (P<0.05), and the 5-year DFS of the high LMR group was higher than that of the low LMR group (P<0.05). Single factor and multivariate COX regression analysis showed that elevated the NLR and PLR were risk factors for the prognosis of breast cancer, and elevated LMR were protective factor(P<0.05). Conclusion: The pCR group had lower NLR and PLR before chemotherapy, higher LMR, and lower 5-year DFS in patients with high NLR, PLR, and low LMR. NLR, PLR and LMR have certain predictive value for the pathological effect of neoadjuvant chemotherapy, and the combination of the three can provide important reference for the evaluation of neoadjuvant chemotherapy for breast cancer. |
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