中性粒细胞与淋巴细胞比值对乳腺癌新辅助治疗的疗效预测  

The Ratio of Neutrophils to Lymphocytes in Predicting the Efficacy of Neoadjuvant Therapy for Breast Cancer

作　　者：郭婉莹 畅昶 刘起鹏[1] 邓淼[1] GUO Wan-ying;CHANG Chang;LIU Qi-peng;DENG Miao(Department of Breast Surgery,The First Affiliated Hospital of Henan University of Science&Technology,Luoyang 471003,Henan Province,China;Department of Pathology,The First Affiliated Hospital of Henan University of Science&Technology,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院乳腺外科,河南洛阳471003 [2]河南科技大学第一附属医院病理科,河南洛阳471003

出　　处：《罕少疾病杂志》2025年第4期33-35,共3页Journal of Rare and Uncommon Diseases

基　　金：2021年度河南省医学科技攻关计划联合共建项目(LHGJ20210601)。

摘　　要：目的中性粒细胞与淋巴细胞比值(NLR)被报道与多种恶性肿瘤化疗疗效相关,可作为化疗疗效的独立预测因素。本研究汇总新辅助治疗NAT)前临床病理学特征及NLR,评估NLR能否成为预测NAT后病理完全缓解率(pCR)的因素。方法我们分析了215例接受NAT的患者对NAT的反应与包括NLR在内的各种因素的相关性。结果在215例患者中,65例(30.2%)获得了pCR。HER2状态、Ki-67指数和NLR与pCR显著相关,差异具有统计学意义。HER2阳性患者的pCR率高于HER2阴性患者(45.3%比20.2%,P<0.001);高Ki-67指数患者的pCR率高于低Ki-67指数患者(32.7%比5.3%,P=0.013);低NLR组患者的pCR率高于高NLR组患者(51.9%比18.1%,P<0.001)。在二元Logistic多因素分析中,低NLR(OR:0.20,95%CI:0.10~0.40)及HER2阳性(OR:3.39,95%CI:1.73~6.63)是pCR的独立影响因素(P均<0.05)。结论本研究结果表明,NLR可以作为NAT后pCR的预测因子。有助于临床医生在新辅助治疗期间动态监测病情,更加有效的识别能通过新辅助治疗获益的人群,指导患者辅助治疗方案的制定并预测疾病预后。Objective Background and Purpose Neutrophil to lymphocyte ratio(NLR)has been reported to be associated with chemotherapy efficacy for a variety of malignancies and can be used as an independent predictor of chemotherapy efficacy.In this study,we summarized the clinicopathological features and NLR before neoadjuvant therapy(NAT)to assess whether NLR could be a factor in predicting pathological complete response(pCR).Methods We analyzed the correlation between responses to NAT in 215 patients receiving NAT and various factors,including NLR.Results pCR was obtained in 65(30.2%)of the 215 patients.HER2 status,Ki-67 index and NLR were significantly correlated with pCR.The pCR rate was higher in HER2-positive patients than in Her2-negative patients(45.3%vs 20.2%,P<0.001).The pCR rate of patients with high Ki-67 index was higher than that of patients with low Ki-67 index(32.7%vs 5.3%,P=0.013).The pCR rate in patients with low NLR was higher than that in patients with high NLR(51.9%vs 18.1%,P<0.001).In binary Logistic multivariate analysis,low NLR(OR:0.20,95%CI:0.10-0.40)and HER2 positive(OR:3.39,95%CI:1.73-6.63)were independent influencing factors of pCR(P<0.05).Conclusion Our results suggest that NLR is a predictor of post-NAT pCR and can be used as a useful predictor and prognostic indicator.It is helpful for clinicians to dynamically monitor during neoadjuvant therapy,more effectively identify the population who can benefit from neoadjuvant therapy,guide the formulation of adjuvant therapy for patients and predict the prognosis of the disease.

关 键 词：乳腺癌 中性粒细胞/淋巴细胞比值 新辅助治疗 病理完全缓解 

分 类 号：R737.9[医药卫生—肿瘤]