Li Yuyong, Shao Yi, Bai Lishan, Zhou Xingwei
Department of Radiology, The Third People's Hospital of Bengbu, Bengbu, Anhui, China.
Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Cancer Manag Res. 2018 Sep 24;10:3841-3847. doi: 10.2147/CMAR.S174537. eCollection 2018.
The prognostic role of the derived neutrophil-to-lymphocyte ratio (dNLR) in human patients with HER2+ breast cancer is not well understood. Here, we aimed to investigate the prognostic significance of dNLR in patients with HER2+ breast cancer undergoing neoadjuvant chemotherapy.
A total of 310 patients with non-distant metastatic HER2+ breast cancer who had received neoadjuvant chemotherapy in our hospital from May 2006 to November 2013 were retrospectively included in this study. Kaplan-Meier curves were used to assess overall survival (OS) and disease-free survival (DFS). The Cox regression model was used to evaluate the prognostic value of dNLR and Breast Imaging-Reporting and Data System (BI-RADS) classification, as well as other clinicopathological parameters in patients with HER2+ breast cancer treated with neoadjuvant chemotherapy.
We found that dNLR prior to treatment was positively correlated with tumor size, tumor stage, lymphovascular invasion, and histological grade (<0.05). The median OS of patients with high dNLR and low dNLR were 44.2 and 69.9, respectively (<0.001), and the median DFS of patients with high dNLR and low dNLR were 15.3 and 22.1 months, respectively (<0.001). Multivariate analysis showed that dNLR was an independent risk factor for OS (HR =1.726; 95% CI: 1.072-2.662; =0.009) and DFS (HR =1.658; 95% CI: 1.125-2.426; =0.026). Moreover, increased BI-RADS classification independently predicted short OS (HR =1.609; 95% CI: 1.216-2.351; =0.015) and DFS (HR =1.925; 95% CI: 1.526-2.635; =0.021).
dNLR prior to treatment and BI-RADS classification are independent prognostic factors in patients with HER2+ breast cancer receiving neoadjuvant chemotherapy.
在人表皮生长因子受体2（HER2）阳性乳腺癌患者中，衍生中性粒细胞与淋巴细胞比值（dNLR）的预后作用尚未完全明确。在此，我们旨在研究dNLR在接受新辅助化疗的HER2阳性乳腺癌患者中的预后意义。
本研究回顾性纳入了2006年5月至2013年11月在我院接受新辅助化疗的310例非远处转移性HER2阳性乳腺癌患者。采用Kaplan-Meier曲线评估总生存期（OS）和无病生存期（DFS）。Cox回归模型用于评估dNLR和乳腺影像报告和数据系统（BI-RADS）分类以及其他临床病理参数在接受新辅助化疗的HER2阳性乳腺癌患者中的预后价值。
我们发现治疗前dNLR与肿瘤大小、肿瘤分期、淋巴管浸润和组织学分级呈正相关（<0.05）。dNLR高和低的患者的中位OS分别为44.2和69.9（<0.001），dNLR高和低的患者的中位DFS分别为15.3和22.1个月（<0.001）。多因素分析显示，dNLR是OS（HR =1.726；95%CI：1.072 - 2.662；=0.009）和DFS（HR =1.658；95%CI：1.125 - 2.426；=0.026）的独立危险因素。此外，BI-RADS分类增加独立预测较短的OS（HR =1.609；95%CI：1.216 - 2.351；=0.015）和DFS（HR =1.925；95%CI：1.526 - 2.635；=0.021）。
治疗前dNLR和BI-RADS分类是接受新辅助化疗的HER2阳性乳腺癌患者的独立预后因素。
