血小板/淋巴细胞比值优于中性粒细胞/淋巴细胞比值，可预测管腔 B 样（HER2）型乳腺癌的化疗反应和无病生存。
Platelet/Lymphocyte Ratio Is Superior to Neutrophil/Lymphocyte Ratio as a Predictor of Chemotherapy Response and Disease-free Survival in Luminal B-like (HER2) Breast Cancer.
机构信息
Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China.
Department of Clinical Laboratory, First Hospital of Changsha, Changsha, China.
出版信息
Clin Breast Cancer. 2020 Aug;20(4):e403-e409. doi: 10.1016/j.clbc.2020.01.008. Epub 2020 Jan 30.
BACKGROUND
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.
PATIENTS AND METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
背景
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。
患者和方法
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。
结果
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。
结论
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。
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