系统性炎症相关指标与乳腺癌临床病理及预后的相关性分析  

Association of systemic inflammation-related indicators with clinicopathological factors and prognosis of breast cancer patients

作　　者：赵佳琳[1] 曹希[1] 彭理[1] 王学晶[1] 任新瑜[2] 孙强[1] ZHAO Jialin;CAO Xi;PENG Li;WANG Xuejing;REN Xinyu;SUN Qiang(Department of Breast Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院,北京协和医院乳腺外科,北京100730 [2]中国医学科学院北京协和医学院,北京协和医院病理科,北京100730

出　　处：《南京医科大学学报（自然科学版）》2021年第1期74-81,113,共9页Journal of Nanjing Medical University(Natural Sciences)

基　　金：北京市科学技术委员会重大专项科技计划(D161100000816005)。

摘　　要：目的:探讨术前外周血中系统性炎症相关指标对乳腺癌患者预后的影响。方法:收集连续收治且符合入选标准的380例乳腺癌患者的外周血指标,根据中性粒细胞和淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板和淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)、淋巴细胞和单核细胞比值(lymphocyte-to-monocyte ratio,LMR)及系统性免疫性炎症指数(systemic immune-inflammation index,SII)水平进行分组,对其中36例三阴性乳腺癌(triple negative breast cancer,TNBC)患者采用免疫组织化学法检测程序性死亡受体配体1(programmed cell death-ligand 1,PD-L1)的表达,并以乳腺癌特异性生存为指标进行预后分析。结果:NLR及SII水平与乳腺癌患者的肿瘤最大径及临床分期有相关性,PLR及LMR水平与乳腺癌患者的临床病理特征无明显相关性;单因素与多因素分析结果显示,高SII组患者的乳腺癌特异性生存不佳。同时,TNBC亚组中PD-L1阳性表达可能与低SII水平存在相关性。结论:术前SII水平可能与乳腺癌患者肿瘤分期及预后相关,TNBC亚组中PD-L1阳性表达可能与低SII水平存在相关性。分析乳腺癌患者术前外周血中系统性炎症相关指标可能为病情监测提供依据。Objective:To analyze prognostic values of systemic inflammation-related indicators in preoperative peripheral blood of breast cancer patients. Methods:Preoperative inflammatory indexes,such as neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),lymphocyte-to-monocyte ratio(LMR)and systemic immune-inflammation index(SII),were obtained from 380 breast cancer patients who complied with the selection criteria. PD-L1 expressions were detected by immunohistochemistry methods in tumor tissues of 36 triple negative breast cancer(TNBC)patients. The survival analysis was performed based on the rate of breast cancer-related death. Results:Levels of NLR and SII were related to maximum tumor diameter and clinical stage of breast cancer patients,while the PLR and LMR had no significant correlations with clinicopathological features. Univariate and multivariate analysis of survival showed that patients with high SII levels had shorter breast cancer specific survival. Meanwhile,levels of SII were probably correlated with PD-L1 expressions in TNBC patients. Conclusion:Preoperative SII levels could be associated with tumor staging and prognosis in breast cancer patients. There may be a correlation between positive PD-L1 expressions and low SII levels in the TNBC subgroup. Systemic inflammation-related indicators of preoperative peripheral blood may provide further choices for disease surveillance of breast cancer patients.

关 键 词：乳腺癌 系统性免疫性炎症指数 肿瘤浸润淋巴细胞 程序性死亡受体配体1 预后 

分 类 号：R737.9[医药卫生—肿瘤]