新辅助化疗前中性粒细胞淋巴细胞比值与乳腺癌化疗疗效及预后的关系

摘要

Objective To investigate the predictive value of baseline neutrophil-to-lymphocyte ratio (NLR) in the curative effect and prognosis of breast cancer patients treated with neoadjuvant chemotherapy.Methods The clinical data of 304 breast cancer patients received neoadjuvant chemotherapy in Beijing Cancer Hospital during 2010 were retrospectively analyzed.The correlations of baseline NLR with clinicopathological parameters of breast cancer patients were analyzed by Wilcox or Kruskal-Wallis tests,and the correlation of NLR with pathologic complete response (pCR) after neoadjuvant chemotherapy was analyzed by the binary logistic regression.The effect of clinic pathological parameters on the disease-free survival(DFS) of the patients was evaluated by the univariable and muhivariable Cox regression models.Results The medians of NLR in pCR + patients (n =62) and pCR-patients (n =242) were 1.76 and 1.72,respectively,and there was no significant difference between themn (P ＞ 0.05).Multivariate analysis indicated that the TNM stage (P ＜ 0.05) and pCR (P ＜ 0.05) were the independent risk factors influencing the prognosis of breast cancer patients.There was no significant correlation between NLR and 5-year DFS (HR=0.842,95％CI=0.566-1.255,P＞0.05).Condusion NLR lacks the predictive value in the curative effect and prognosis of breast cancer patients treated with neoadjuvant chemotherapy,while TNM stage and pCR are the independent risk factors influencing the prognosis of breast cancer patients.%目的 探讨中性粒细胞淋巴细胞比值(NLR)对乳腺癌患者新辅助化疗疗效预测及预后的价值.方法 回顾性分析2010年于北京肿瘤医院乳腺中心接受新辅助化疗的304例乳腺癌患者的临床资料.Wilcox秩和检验或Kruskal-Wallis秩和检验分析NLR与患者临床病理因素的相关性,Logistic回归分析NLR与患者新辅助化疗后病理性完全缓解(pCR)的关系,单因素及多因素生存分析评价临床病理因素对患者生存的影响.结果 pCR+组(n=62)和pCR-组(n =242)患者NLR中位数分别为1.76和1.72,二者差异无统计学意义(P＞0.05).多因素分析表明肿瘤临床分期(TNM) (P ＜0.05)和pCR(P ＜0.05)均是影响乳腺癌患者预后的独立危险因素.NLR与乳腺癌患者五年无病生存期无明显相关性(HR=0.842,95％ CI=0.566 ～1.255,P＞0.05).结论 NLR在乳腺癌患者化疗疗效预测及预后方面未发现其价值.TNM分期和pCR是乳腺癌患者预后的独立危险因素.