治疗前全身炎症反应指数对乳腺癌新辅助化疗病理完全缓解的预测价值  

Predictive value of systemic inflammation response index before treatment for pathological complete response in patients with breast cancer undergoing neoadjuvant chemotherapy

作　　者：刘永红[1] 薛玲博 白杨[1] 靳健 臧春霞[2] 张博[1] 李杰[1] Liu Yonghong;Xue Lingbo;Bai Yang;Jin Jian;Zang Chunxia;Zhang Bo;Li Jie(Fourth Department of Thyroid and Breast Surgery,Cangzhou Central Hospital of Hebei Province,Cangzhou 061000,China;First Department of Thyroid and Breast Surgery,Cangzhou Central Hospital of Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院甲状腺乳腺外四科,沧州061000 [2]河北省沧州市中心医院甲状腺乳腺外一科,沧州061000

出　　处：《国际肿瘤学杂志》2022年第4期210-215,共6页Journal of International Oncology

基　　金：沧州市科学计划自筹经费项目(183302024)。

摘　　要：目的探讨治疗前全身炎症反应指数(SIRI)对乳腺癌新辅助化疗病理完全缓解(pCR)的预测价值。方法回顾性分析2010年1月至2020年3月河北省沧州市中心医院确诊并接受新辅助化疗和乳腺癌保乳或改良根治术的119例原发性乳腺癌患者的临床资料,根据患者的术后病理分为pCR组(n=19)和非pCR组(n=100)。比较两组患者治疗前SIRI。依据治疗前SIRI分为SIRI≤0.25(n=10)、0.26~0.50(n=42)、0.51~0.75(n=29)、0.76~1.00(n=19)及>1.00(n=19)共5组,比较5组患者的pCR率。通过Spearman相关性分析评估治疗前SIRI与pCR的相关性,采用logistic回归分析乳腺癌患者新辅助化疗pCR的影响因素,受试者工作特征(ROC)曲线评估治疗前SIRI对乳腺癌新辅助化疗pCR的预测价值。结果pCR和非pCR两组患者在肿瘤大小(Z=2.26,P=0.024)、腋窝淋巴结转移(χ^(2)=5.73,P=0.017)、人表皮生长因子受体-2(HER-2)(χ^(2)=8.77,P=0.003)、Ki-67(Z=2.68,P=0.007)、细胞学核分级(χ^(2)=5.08,P=0.024)、治疗前中性粒细胞计数(Z=2.44,P=0.015)、治疗前单核细胞/淋巴细胞计数比值(Z=3.04,P=0.002)及治疗前SIRI(Z=3.29,P=0.001)方面差异均具有统计学意义。治疗前SIRI≤0.25组的pCR率为50%(5/10),0.26~0.50组为21%(9/42),0.51~0.75组为10%(3/29),0.76~1.00组为11%(2/19),>1.00组为0(0/19),差异具有统计学意义(χ^(2)=14.28,P=0.006)。患者治疗前SIRI与pCR呈负相关(r=-0.30,P=0.001)。单因素logistic回归分析显示,肿瘤大小(OR=0.50,95%CI为0.28~0.89,P=0.019)、腋窝淋巴结转移(OR=5.43,95%CI为1.19~24.83,P=0.029)、HER-2(OR=7.54,95%CI为1.65~34.36,P=0.009)、Ki-67(OR=1.03,95%CI为1.01~1.05,P=0.008)、细胞学核分级(OR=0.20,95%CI为0.04~0.92,P=0.038)、治疗前中性粒细胞计数(OR=0.54,95%CI为0.32~0.92,P=0.023)、治疗前单核细胞/淋巴细胞计数比值(OR=0.00,95%CI为0.00~0.01,P=0.007)及治疗前SIRI(OR=0.03,95%CI为0.00~0.37,P=0.007)为乳腺癌患者新辅助化疗pCR的影响因素。多因素logistic回归分析显示,肿瘤Objective To investigate the predictive value of systemic inflammation response index(SIRI)before treatment for pathological complete response(pCR)in patients with breast cancer undergoing neoadjuvant chemotherapy.Methods The clinicopathological data of 119 patients with primary breast cancer undergoing neoadjuvant chemotherapy and subsequent breast-conserving or modified radical surgery from Cangzhou Central Hospital of Hebei Province between January 2010 to March 2020 were retrospectively analyzed,and patients were divided into pCR group(n=19)and non-pCR group(n=100)based on postoperative pathology.The SIRI before treatment between the two groups was compared.The patients were divided into SIRI≤0.25(n=10),0.26-0.50(n=42),0.51-0.75(n=29),0.76-1.00(n=19),and>1.00(n=19)groups according the SIRI before treatment,and the pCR ratios of the five groups were compared.Spearman correlation analysis was applied to evaluate the relationship between SIRI before treatment and pCR,logistic regression analysis was used to identify the influencing factors of pCR for neoadjuvant chemotherapy in breast cancer patients,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of SIRI before treatment for pCR of neoadjuvant chemotherapy in breast cancer patients.Results Tumor size(Z=2.26,P=0.024),axillary lymph node metastasis(χ^(2)=5.73,P=0.017),human epidermal growth factor receptor-2(HER-2)(χ^(2)=8.77,P=0.003),Ki-67(Z=2.68,P=0.007),cytological nuclear grade(χ^(2)=5.08,P=0.024),neutrophil count before treatment(Z=2.44,P=0.015),monocyte/lymphocyte ratio before treatment(Z=3.04,P=0.002),and SIRI before treatment(Z=3.29,P=0.001)had statistical differences between the pCR and non-pCR groups.The pCR ratios were 50%(5/10)in the SIRI≤0.25 group,21%(9/42)in the 0.26-0.50 group,10%(3/29)in the 0.51-0.75 group,11%(2/19)in the 0.76-1.00 group,and 0(0/19)in the>1.00 group,with a statistic difference(χ^(2)=14.28,P=0.006).SIRI before treatment was negatively related with pCR(r=-0.30,P=0.001).Univariate l

关 键 词：乳腺肿瘤 新辅助化疗 炎症 

分 类 号：R737.9[医药卫生—肿瘤]