三阴性乳腺癌根治术患者术前炎症相关指标与预后的相关性  

Correlation between preoperative inflammation-related indicators and prognosis in triple-negative breast cancer patients undergoing radical mastectomy

作　　者：周阳 刘鹏 付晨瑜 郭腾飞 刘烁 ZHOU Yang;LIU Peng;FU Chenyu;GUO Tengfei;LIU Shuo(Department of Pharmacy and Laboratory,Heze Medical College,Shandong Province,Heze 274000,China;Clinical Laboratory,Linyi Economic and Technological Development Zone People's Hospital,Shandong Province,Linyi 276000,China;Department of Traditional Chinese Medicine,Heze Medical College,Shandong Province,Heze 274000,China;Central Laboratory,Scientific Research Division,Heze Medical College,Shandong Province,Heze 274000,China;Clinical Laboratory,Heze Hospital of Shandong Provincial Hospital,Shandong Province,Heze 274000,China)

机构地区：[1]菏泽医学专科学校药学与检验系,山东菏泽274000 [2]山东省临沂经济技术开发区人民医院检验科,山东临沂276000 [3]菏泽医学专科学校中医药系,山东菏泽274000 [4]菏泽医学专科学校科研处中心实验室,山东菏泽274000 [5]山东省立医院菏泽医院检验科,山东菏泽274000

出　　处：《中国当代医药》2025年第5期17-22,28,共7页China Modern Medicine

基　　金：山东省医药卫生科技发展计划项目(202102081098)。

摘　　要：目的探讨三阴性乳腺癌(TNBC)患者术前相关炎症指标对其生存预后的预测价值。方法选取2018年1月至2020年5月菏泽市立医院收治的280例接受乳腺癌根治术的TNBC患者作为研究对象,收集患者临床基线特征和术前相关炎症指标,包括系统性免疫性炎症指数(SII)水平、中性粒细胞与淋巴细胞计数比(NLR)、血小板和淋巴细胞比值(PLR)、淋巴细胞/单核细胞比值(LMR)。对临床基线特征进行单因素Cox分析。根据受试者工作特征曲线(ROC)确定上述炎症相关指标临界值,采用Kaplan-Meier法绘制生存曲线,Log-rank检验进行生存分析,多因素分析评估相关因素预后价值。结果280例患者中位生存率为34.09个月,单因素Cox分析结果显示,TNBC患者的年龄、肿瘤分期、肿瘤最大径、淋巴结转移、接受化疗是预后影响因素(P<0.05)。不同炎症指标诊断乳腺癌术后复发转移情况的能力有所差别,术前炎症指标的截断值SII=546.86,NLR=2.27,PLR=128.54,LMR=5.20。多因素Cox分析结果显示肿瘤分期Ⅱ期(β=1.131,OR=3.099,95%CI:1.308~7.345)、肿瘤分期Ⅲ期(β=1.836,OR=6.269,95%CI:2.778~14.149)、肿瘤最大径2~5 cm(β=0.808,OR=2.243,95%CI:1.146~4.388)、肿瘤最大径>5 cm(β=1.308,OR=2.765,95%CI:1.864~7.342)、发生淋巴结转移(β=1.017,OR=2.765,95%CI:1.537~4.975)、PLR≥128.54(β=0.449,OR=1.567,95%CI:1.038~2.366)是TNBC患者无病生存期的独立危险因素(P<0.05),LMR≥5.20(β=-0.730,OR=0.482,95%CI:0.292~0.796)是TNBC患者无病生存期的独立保护因素(P<0.05)。结论肿瘤分期、肿瘤最大径、发生淋巴结转移、PLR、LMR可以作为TNBC患者的生存预后的独立影响因素。Objective To investigate the predictive value of preoperative related inflammatory indicators for survival prognosis of patients with triple negative breast cancer(TNBC).Methods A total of 280 patients with TNBC who underwent radical mastectomy in Heze Municipal Hospital from January 2018 to May 2020 were selected as the research objects.Clinical baseline characteristics and preoperative inflammation-related indicators,including systemic immune inflammation index(SII)level,neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and lymphocyte/monocyte ratio(LMR)were collected.Univariate Cox analysis was performed on clinical baseline characteristics.The critical values for the above inflammation-related indicators were determined using receiver operating characteristic curve analysis.Survival curves were plotted using the Kaplan-Meier method,and survival analysis was conducted using Log-rank test.Multivariate analysis was used to evaluate the prognostic value of related factors.Results The median survival rate of 280 patients was 34.09 months.Univariate Cox analysis showed that age,tumor stage,tumor maximum diameter,lymph node metastasis,and chemotherapy were the prognostic factors of TNBC patients(P<0.05).There were different diagnostic values for postoperative recurrence and metastasis of breast cancer by different inflammatory markers.The cut-off values of preoperative inflammatory indicators were SII=546.86,NLR=2.27,PLR=128.54,LMR=5.20.Tumor stageⅡ(β=1.131,OR=3.099,95%CI:1.308-7.345),tumor stageⅢ(β=1.836,OR=6.269,95%CI:2.778-14.149),tumor maximum diameter 2~5 cm(β=0.808,OR=2.243,95%CI:1.146-4.388),tumor maximum diameter>5 cm(β=1.308,OR=2.765,95%CI:1.864-7.342),lymph node metastasis(β=1.017,OR=2.765,95%CI:1.537-4.975),PLR≥128.54(β=0.449,OR=1.567,95%CI:1.038-2.366)were independent risk factors for disease-free survival of TNBC patients(P<0.05),LMR≥5.20(β=-0.730,OR=0.482,95%CI:0.292-0.796)was independent protective factor for disease-free survival of TNBC patients(P<0.05).Conclusion Tumor s

关 键 词：三阴型乳腺癌 预后 系统性免疫性炎症 中性粒细胞和淋巴细胞比值 血小板和淋巴细胞比值 淋巴细胞和单核细胞比值 

分 类 号：R737.9[医药卫生—肿瘤]