系统免疫炎症指数与新辅助化疗乳腺癌预后的相关性分析  

Correlation between Systemic Immune Inflammation Index with Prognoses of Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy

作　　者：魏宇昕[1] 关胜男[1] 姜丽[1] WEI Yu-xin;GUAN Sheng-nan;JIANG Li(Department of Oncology and Laparoscopy Surgery,the First Hospital Affiliated to Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院肿瘤腔镜外科,哈尔滨150000

出　　处：《临床误诊误治》2022年第2期44-49,共6页Clinical Misdiagnosis & Mistherapy

基　　金：黑龙江省自然科学基金项目(2018RFXYS053)。

摘　　要：目的探讨系统免疫炎症指数(SII)对新辅助化疗乳腺癌患者病理完全缓解(pCR)及预后的影响。方法回顾性分析2015年2月—2020年2月行新辅助化疗的378例乳腺癌的临床资料。比较化疗前不同水平SII患者的临床特征差异及预后情况,受试者工作特征(ROC)曲线分析中性粒细胞与淋巴细胞比值(NLR)和SII预测pCR的效能,多因素Logistic回归分析影响pCR的危险因素。结果经新辅助化疗后共72例获得pCR,pCR率为19.05%。新辅助化疗前SII预测乳腺癌患者获得pCR的ROC曲线下面积为0.831,高于NLR的0.760(P<0.01)。高SII组总生存期、生存率、年龄、白蛋白水平均低于低SII组,NLR水平、临床分期Ⅲ~Ⅳ期、有脉管瘤栓、Ki-67表达>14%比率高于低SII组(P<0.05,P<0.01)。NLR>2.35、SII>658.27、有脉管瘤栓、临床分期Ⅲ~Ⅳ期是新辅助化疗乳腺癌患者未获得pCR的独立危险因素(P<0.05,P<0.01)。结论SII升高是新辅助化疗乳腺癌患者未获得pCR的独立危险因素,且与患者预后不良有关。Objective To explore effects of systemic immune inflammation index(SII)on pathological complete remission(pCR)and prognoses of patients with breast cancer undergoing neoadjuvant chemotherapy.Methods Clinical data of 378 patients with breast cancer who had underwent neoadjuvant chemotherapy between February 2015 and February 2020 was retrospectively analyzed.The differences in clinical characteristics and prognoses of patients with different levels of SII before chemotherapy were compared.Receiver operating characteristic(ROC)curve was used to analyze the efficacies of neutrophil to lymphocyte ratio(NLR)and SII in predicting pCR.Multivariate logistic regression analysis was used to analyze the risk factors affecting pCR.Results A total of 72 patients obtained pCR after neoadjuvant chemotherapy,and the pCR rate was 19.05%.The area under the ROC curve of SII in predicting the obtainment of pCR in breast cancer patients before neoadjuvant chemotherapy was 0.831,which was significantly higher than 0.760 of the NLR(P<0.01).In high SII group,values of overall survival,survival rate,age and albumin level were significantly lower,while values of NLR level,TNM stagesⅢ-Ⅳ,having vascular tumor thrombus,and ratio of Ki-67 expression more than 14%were significantly higher than those in low SII group(P<0.05,P<0.01).NLR more than 2.35,SII more than 658.27,having vascular tumor thrombus and TNM stageⅢ-Ⅳwere independent risk factors for failure to obtain pCR in breast cancer patients undergoing neoadjuvant chemotherapy(P<0.05,P<0.01).Conclusion Elevated SII is an independent risk factor for failure to obtain pCR in breast cancer patients undergoing neoadjuvant chemotherapy,and it is related to the poor prognoses of patients.

关 键 词：乳腺肿瘤 系统免疫炎症指数 病理完全缓解 预后 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]