术前外周血NLR在乳腺癌患者预后评估中的价值分析  

The Value of Preoperative Peripheral Blood NLR in the Prognosis Evaluation of Patients with Breast Cancer

作　　者：李华琼[1] 张成 范雪娇[1] 郑柳[1] 谢亮[1] 吴先麟[1] LI Huaqiong;ZHANG Cheng;FAN Xuejiao;ZHENG Liu;XIE Liang;WU Xianlin(Department of General Surgery,Chengdu Sixth People′s Hospital,Chengdu 610051,China)

机构地区：[1]成都市第六人民医院普外科,四川成都610051

出　　处：《标记免疫分析与临床》2020年第6期947-952,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨术前外周血中性粒细胞/淋巴细胞比值(NLR)与乳腺癌患者预后的关系,评价NLR作为预后评估指标的临床价值。方法对80例行手术及辅助治疗的初诊原发性乳腺癌患者进行回顾性分析。根据ROC曲线分析所得NLR临界值分为高NLR组和低NLR组,分析NLR与临床病理特征的相关性。采用Kaplan-Meier法进行生存分析,以Log-rank检验比较两组5年无进展生存(PFS)率及总生存(OS)率,ROC曲线分析NLR对预后的预测价值,并采用COX比例风险模型进行多因素分析。结果中位随访时间为57个月。ROC曲线分析显示,NLR=1.40作为临界值,NLR预测患者预后灵敏度为76.2%,特异性为78.0%。Kaplan-Meier生存分析显示,高NLR组5年PFS率为65.1%,明显低于低NLR组的78.2%(P=0.009)。高NLR组与低NLR组5年OS率分别为74.3%和80.6%,差异无统计学意义(P=0.313)。多因素COX比例风险模型回归分析显示,术前NLR是乳腺癌患者5年PFS率的独立相关因素(HR=1.812,95%CI:1.211~2.795,P=0.021)。结论术前外周血NLR与乳腺癌患者PFS密切相关,可作为预后的独立预测指标。Objective To investigate the relationship between preoperative peripheral blood neutrophil/lymphocyte ratio(NLR)and prognosis of patients with breast cancer,and evaluate the clinical value of NLR as a prognostic indicator.Methods A retrospective analysis was performed in 80 patients with newly diagnosed primary breast cancer who underwent surgery and adjuvant therapy.The subjects were divided into the high NLR group and low NLR group according to the critical value of NLR obtained by ROC curve analysis,and the correlation between NLR and clinicopathological features was analyzed.The survival analysis was performed by the Kaplan-Meier method,and the 5-year progression-free survival(PFS)rates and overall survival(OS)rates were compared between the two groups by the log-rank test.The predictive value of NLR for the prognosis was analyzed with ROC curve.Multivariate analysis was performed using the COX proportional hazard model.Results The median follow-up time was 57 months.ROC curve analysis showed that when taking NLR=1.40 as the critical value,the sensitivity and specificity of NLR for predicting the prognosis were 76.2%and 78.0%,respectively.Kaplan-Meier survival analysis showed that the 5-year PFS rate of the high NLR group was significantly lower than that of the low NLR group(65.1%vs 78.2%)(P=0.009).The 5-year OS rates of the high NLR group and the low NLR group were 74.3%and 80.6%,respectively(P=0.313).Multivariate COX proportional hazard regression analysis showed that preoperative NLR was an independent relevant factor of 5-year PFS rate of patients with breast cancer(HR=1.812,95%CI:1.211 to 2.795,P=0.021).Conclusion Preoperative peripheral blood NLR is closely related to PFS of patients with breast cancer and it can be used as an independent predictor of prognosis.

关 键 词：乳腺癌 中性粒细胞/淋巴细胞比值 无病生存率 预测 

分 类 号：R737.9[医药卫生—肿瘤]