Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China.
Department of Clinical Laboratory, First Hospital of Changsha, Changsha, China.
Clin Breast Cancer. 2020 Aug;20(4):e403-e409. doi: 10.1016/j.clbc.2020.01.008. Epub 2020 Jan 30.
The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been associated with the prognosis in breast cancer (BC). The relationship of the NLR and PLR with chemotherapy sensitivity and prognosis in luminal B-like (human epidermal growth factor receptor 2-negative [HER2]) BC are not well studied.
The clinical data from 980 patients with luminal B-like (HER2) BC from June 2012 to June 2016 were collected. The differences among the variables were calculated using the χ test. The associations among the clinicopathologic factors, pretreatment NLR, pretreatment PLR, and disease-free survival (DFS) were analyzed using Kaplan-Meier curves and Cox analyses.
The median follow-up was 37 months (range, 5-77 months). For the 480 patients who had received neoadjuvant chemotherapy, low pretreatment PLR values were associated with higher pathologic complete response (pCR) rates compared with the high PLR group (15.8% for low vs. 9.2% for high PLR group; P = .027). Multivariate analyses showed that larger tumors, a greater number of lymph nodes involved, a high Ki-67 score, and a high PLR were independent prognostic factors of worse outcomes for the patients with luminal B-like (HER2) BC. The risk of metastasis and/or recurrence was greater for the high PLR group than for the low PLR group (hazard ratio, 1.576; 95% confidence interval, 1.039-2.390; P = .032). The pretreatment NLR showed no such associations among this cohort of patients.
The results of the present study have shown that the pretreatment PLR is superior to the NLR as a predictor of pCR and DFS outcomes in patients with luminal B-like (HER2) BC. A low pretreatment PLR was associated with higher pCR rates after neoadjuvant chemotherapy and was an independent predictive factor for better DFS outcomes among patients with luminal B-like (HER2) BC.
中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）与乳腺癌（BC）的预后相关。NLR 和 PLR 与 luminal B 样（人表皮生长因子受体 2 阴性 [HER2]）BC 化疗敏感性和预后的关系尚未得到很好的研究。
收集了 2012 年 6 月至 2016 年 6 月间 980 例 luminal B 样（HER2）BC 患者的临床资料。采用 χ 检验计算变量间差异。采用 Kaplan-Meier 曲线和 Cox 分析分析临床病理因素、治疗前 NLR、治疗前 PLR 与无病生存（DFS）的关系。
中位随访时间为 37 个月（范围，5-77 个月）。对于接受新辅助化疗的 480 例患者，低治疗前 PLR 值与较高的病理完全缓解（pCR）率相关，与高 PLR 组相比（15.8%比高 PLR 组 9.2%；P=0.027）。多因素分析显示，肿瘤较大、淋巴结转移较多、Ki-67 评分较高和 PLR 较高是 luminal B 样（HER2）BC 患者预后不良的独立预后因素。高 PLR 组转移和/或复发的风险高于低 PLR 组（危险比，1.576；95%置信区间，1.039-2.390；P=0.032）。该队列患者的治疗前 NLR 无此相关性。
本研究结果表明，治疗前 PLR 优于 NLR，可预测 luminal B 样（HER2）BC 患者 pCR 和 DFS 结局。新辅助化疗后，低治疗前 PLR 与较高的 pCR 率相关，是 luminal B 样（HER2）BC 患者更好 DFS 结局的独立预测因素。
