术前中性粒细胞/淋巴细胞比值在三阴性乳腺癌患者预后评估中的应用

摘要

Objective To assess the correlation between preoperative neutrophil-to-lymphocyte ratio (NLR) and the prognostic significance in patients with triple-negative breast cancer (TNBC). Method The clinical profiles of 108 TNBC patients were retrospectively analyzed. According to the ROC curve, we selected NLR=2.02 as a critical value with bal-anced sensitivity and specificity, and then the 108 patients were divided as low NLR group (n=52, NLR≤2.02) or high NLR group (n=56, NLR>2.02), of which the clinical pathology data, progression free survival (PFS) and 5-year survival rate were determined. Result The 5-year survival rate in low and high NLR group was 87.8%and 80.2%(P<0.01), and the median PFS was 58.2 months vs 44.5 months, respectively (P<0.01). Higher NLR values were significantly associated with more lymph node metastases, higher pathological stage and histological classifications (P<0.01). Cox regression model analysis showed that the number of lymph nodes metastases, pathological stage, histological classifications and NLR were the factors influencing the survival of TNBC patients. Conclusion For TNBC patients, higher preoperative NLR indicates a higher postoperative stage and histological classifications, besides, patients with higher preoperative NLR may have poorer progression free survival and lower 5-year survival rate. Preoperative NLR can be used as prognos-tic marker in TNBC patients.%目的 探讨术前中性粒细胞/淋巴细胞比值(NLR)在三阴性乳腺癌患者预后评估中的应用.方法回顾性分析108例三阴性乳腺癌患者的临床资料,根据受试者工作特征曲线,兼顾敏感度和特异度,选取NLR=2.02为临界值,将108例患者分为低NLR组(n=52,NLR≤2.02﹚和高NLR组(n=56,NLR﹥2.02).分析两组患者的临床病理特征、无疾病进展时间及5年生存率.结果低NLR组和高NLR组患者的5年生存率分别为87.8%和80.2%(P﹤0.01),中位无疾病进展时间分别为58.2个月和44.5个月(P﹤0.01).高NLR组患者的淋巴结转移个数明显多于低NLR组,病理分期和组织学分级明显高于低NLR组,差异均有统计学意义(P﹤0.01).Cox回归分析结果显示,淋巴结转移个数、病理分期、组织学分级、NLR是影响三阴性乳腺癌患者生存的独立危险因素.结论对于三阴性乳腺癌患者,术前高NLR可能预示着术后较高的病理分期和组织学分级,术前高NLR患者的无疾病进展时间更短,5年生存率更低.术前NLR有望成为三阴性乳腺癌患者预后的判断指标.