血小板与淋巴细胞比值及中性粒细胞与淋巴细胞比值对乳腺癌新辅助治疗效果的预测价值  

Predictive value of blood platelet-lymphocyte ratio and neutrophil-lymphocyte ratio in the therapeutic efficacy of neoadjuvant therapy for breast cancer patients

作　　者：倪静怡[1] 张珣磊 张葆春 高湘湘[1] 李兴慧[2] 金聪慧[1] Ni Jingyi;Zhang Xunlei;Zhang Baochun;Gao Xiangxiang;Li Xinghui;Jin Conghui(Department of Breast Medicine,Nantong Tumor Hospital(Tumor Hospital Affiliated to Nantong University),Nantong 226361,China;Department of Breast Surgery,Nantong Tumor Hospital(Tumor Hospital Affiliated to Nantong University),Nantong 226361,China)

机构地区：[1]南通大学附属肿瘤医院、南通市肿瘤医院乳腺内科,南通226361 [2]南通大学附属肿瘤医院、南通市肿瘤医院乳腺外科,南通226361

出　　处：《肿瘤研究与临床》2023年第1期18-22,共5页Cancer Research and Clinic

基　　金：江苏省南通市科技计划指导性项目(JCZ21109)。

摘　　要：目的探讨血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)的变化对乳腺癌新辅助治疗效果的预测价值。方法回顾性分析2020年2月至2022年1月在南通市肿瘤医院接受新辅助治疗的72例Ⅲ期浸润性乳腺癌患者的临床资料,分析新辅助治疗前后PLR、NLR的变化。采用受试者工作特征(ROC)曲线评估PLR、NLR及其变化对新辅助治疗后达到病理完全缓解(pCR)的预测价值。结果治疗前PLR、治疗前NLR、治疗前后PLR的差值(ΔPLR)、治疗前后NLR的差值(ΔNLR)预测pCR的ROC曲线下面积分别为0.520、0.505、0.724及0.686,截断值分别为269.231、2.559、-2.840及-1.457,根据截断值分组。治疗前NLR与患者临床病理特征均无相关性(均P>0.05),治疗前PLR与肿瘤长径相关(P=0.029),ΔPLR与孕激素受体表达(P=0.025)、人表皮生长因子受体2表达(P<0.001)、分子分型(P<0.001)、N分期(P=0.002)、临床分期(P=0.002)及治疗方案(P<0.001)均相关,ΔNLR与人表皮生长因子受体2表达(P=0.002)、分子分型(P=0.024)、肿瘤长径(P=0.007)、神经侵犯(P=0.006)、N分期(P=0.006)、临床分期(P=0.016)及治疗方案(P=0.014)均相关。ΔPLR、ΔNLR是患者新辅助治疗后达pCR的影响因素(均P<0.05)。结论Ⅲ期浸润性乳腺癌患者新辅助治疗后ΔPLR和ΔNLR较高者预后较好。Objective To investigate the predictive value of the changes of platelet-lymphocyte ratio(PLR)and neutrophil-lymphocyte ratio(NLR)in the therapeutic efficacy of the neoadjuvant treatment for breast cancer.Methods The clinical data of 72 breast cancer patients who received neoadjuvant therapy in Nantong Tumor Hospital between February 2020 and January 2022 were retrospectively analyzed and the changes of PLR and NLR before and after neoadjuvant therapy were also analyzed.The receiver operating characteristic(ROC)curves were used to assess the predictive value of PLR,NLR and their changes in pathological complete remission(pCR)after neoadjuvant therapy.Results The area under the ROC curve of PLR and NLR before the treatment,the difference in PLR before and after the treatment(ΔPLR),the difference in NLR before and after the treatment(ΔNLR)in predicting pCR was 0.520,0.505,0.724 and 0.686,and the corresponding cut-off value was 269.231,2.559,-2.840 and-1.457;the patients were divided into high and low groups according to the cut-off values.NLR before the treatment was not correlated with clinicopathological characteristics(all P>0.05),while PLR before the treatment was correlated with tumor size(P=0.029),andΔPLR was correlated with progesterone receptor expression(P=0.025),human epidermal growth factor receptor 2(HER2)expression(P<0.001),molecular subtype(P<0.001),N stage(P=0.002),clinical stage(P=0.002)and treatment modality(P<0.001).ΔNLR was associated with HER2 expression(P=0.002),molecular subtype(P=0.024),tumor size(P=0.007),neural invasion(P=0.006),N stage(P=0.006),clinical stage(P=0.016)and treatment modality(P=0.014).ΔPLR andΔNLR were influencing factors for patients achieving pCR after neoadjuvant therapy(all P<0.05).Conclusions StageⅢinvasive breast cancer patients with higherΔPLR andΔNLR after neoadjuvant therapy have better prognosis.

关 键 词：乳腺肿瘤 新辅助治疗 血小板与淋巴细胞比值 中性粒细胞与淋巴细胞比值 

分 类 号：R737.9[医药卫生—肿瘤]