Ulas Arife, Avci Nilufer, Kos Tugba, Cubukcu Erdem, Olmez Omer Fatih, Bulut Nilufer, Degirmenci Mustafa
Department of Medical Oncology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
J BUON. 2015 May-Jun;20(3):714-22.
To investigate whether the pretreatment neutrophil lymphocyte ratio (NLR) and the platelet lymphocyte ratio (PLR) have any prognostic significance in patients with HER2-positive early breast cancer receiving adjuvant trastuzumab.
187 patients were retrospectively analyzed. The patients were separated into two groups according to the mean value of NLR and PLR (low NLR≤2.38, high NLR>2.38; and low PLR≤161.28, high PLR>161.28, respectively). The relationship between pretreatment NLR, PLR and clinicopathological factors was investigated. Univariate and multivariate Cox regression analyses were performed. To evaluate survival rates, the Kaplan-Meier method with log rank test were used.
The median duration of follow up was 26.0 months (range 6.0-84.0). In high NLR and PLR groups, the mean age was lower, tumor size was larger and the number of hormone receptor positive patients was higher. No statistically significant relationship was found between clinicopathological factors and both NLR and PLR groups. During follow up, the rate of relapse was 12.6% in the low NLR group, 16.2 % in the high NLR group, 12.6% in the low PLR group and 15.8% in the high PLR group (p=non significant). Although median disease free survival (DFS) was shorter in the high NLR than in the low NLR group, the difference was not statistically significant (p=0.45). No statistically significant difference was found between high and low PLR groups with regard to median DFS and overall survival (OS) (p=0.76, p=0.29, respectively).
We conclude that in HER2-positive early breast cancer patients receiving adjuvant trastuzumab with high pretreatment NLR, DFS was shorter. As for PLR, no effect either on DFS or on OS was registered. Prospective studies with larger number of patients are required in order to evaluate the prognostic effect of NLR and PLR in HER2-positive breast cancer patients.
探讨预处理中性粒细胞淋巴细胞比值（NLR）和血小板淋巴细胞比值（PLR）对接受辅助曲妥珠单抗治疗的HER2阳性早期乳腺癌患者是否具有预后意义。
回顾性分析187例患者。根据NLR和PLR的平均值将患者分为两组（低NLR≤2.38，高NLR>2.38；低PLR≤161.28，高PLR>161.28）。研究预处理NLR、PLR与临床病理因素之间的关系。进行单因素和多因素Cox回归分析。为评估生存率，采用Kaplan-Meier法和对数秩检验。
中位随访时间为26.0个月（范围6.0 - 84.0）。在高NLR和PLR组中，平均年龄较低，肿瘤大小较大，激素受体阳性患者数量较多。临床病理因素与NLR和PLR组之间均未发现有统计学意义的关系。随访期间，低NLR组的复发率为12.6%，高NLR组为16.2%，低PLR组为12.6%，高PLR组为15.8%（p =无显著性差异）。虽然高NLR组的无病生存期（DFS）中位数低于低NLR组，但差异无统计学意义（p = 0.45）。高PLR组和低PLR组在中位DFS和总生存期（OS）方面均未发现有统计学意义的差异（分别为p = 0.76，p = 0.29）。
我们得出结论，在接受辅助曲妥珠单抗治疗的HER2阳性早期乳腺癌患者中，预处理NLR高者DFS较短。至于PLR，对DFS和OS均未显示有影响。需要进行更大规模患者的前瞻性研究，以评估NLR和PLR对HER2阳性乳腺癌患者的预后影响。
