Liu Shaoqing, Fang Jing, Jiao Dechuang, Liu Zhenzhen
Department of Breast Surgery, Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
Cancer Manag Res. 2020 Jul 20;12:6069-6075. doi: 10.2147/CMAR.S257727. eCollection 2020.
More and more studies show that platelets are closely related to the occurrence and development of tumors. This study aims to explore the predictive value of peripheral blood platelet count on the prognosis of breast cancer patients with ipsilateral supraclavicular lymph node (ISLN) metastasis.
Eighty-five breast cancer patients with ISLN metastasis in the Affiliated Cancer Hospital of Zhengzhou University were collected retrospectively in this study. Chi-square test was used to analyze the correlation between clinical pathological data and platelet count. DFS rate was estimated by K-M curve and Log Rank test was performed. Univariate and multivariate Cox regression were used to determine the prognostic value of platelets. Time-dependent Cox regression was used to further analyze the correlation between peripheral blood platelets and prognosis to determine the stability of the results.
The pathological complete response rate of ISLN after neoadjuvant chemotherapy (NAC) was 51.8%. Platelet count was correlated with PR status of breast cancer at first visit (=0.01). After a median follow-up of 30 months, multivariate Cox analysis showed that high platelet count (HR=3.18, 95% CI=1.13-8.93, =0.028), premenopausal status (HR=0.40, 95% CI=0.17-0.97, =0.043), and ISLN pathological failure (HR=0.25 95%, CI=0.10-0.62, <0.01) were associated with poor prognosis. K-M curve analysis showed that the prognosis of patients with a high platelet count was worse than that of patients with low platelet count (HR=5.32, 95% CI=2.41-11.75, <0.01). To further verify the stability of this result, multivariate time-dependent Cox model also suggested that higher platelet level was related to poor prognosis (HR=1.009, 95% CI=1.003-1.016, <0.01). Meanwhile, menopausal status (HR=0.32, 95% CI=0.14-0.76, =0.01) and sPCR (HR=0.29, 95% CI=0.12-0.70, =0.01) were also independent predictors of DFS.
Platelets have important predictive value for the prognosis of breast cancer patients with ISLN metastasis, which indicates that platelet count can be used to distinguish high-risk patients so as to obtain clinical benefits.
越来越多的研究表明，血小板与肿瘤的发生发展密切相关。本研究旨在探讨外周血血小板计数对同侧锁骨上淋巴结（ISLN）转移的乳腺癌患者预后的预测价值。
本研究回顾性收集了郑州大学附属肿瘤医院85例发生ISLN转移的乳腺癌患者。采用卡方检验分析临床病理数据与血小板计数之间的相关性。通过K-M曲线估计无病生存率（DFS），并进行Log Rank检验。采用单因素和多因素Cox回归分析确定血小板的预后价值。采用时间依赖性Cox回归进一步分析外周血血小板与预后的相关性，以确定结果的稳定性。
新辅助化疗（NAC）后ISLN的病理完全缓解率为51.8%。血小板计数与首次就诊时乳腺癌的PR状态相关（P=0.01）。中位随访30个月后，多因素Cox分析显示，血小板计数高（HR=3.18，95%CI=1.13-8.93，P=0.028）、绝经前状态（HR=0.40，95%CI=0.17-0.97，P=0.043）和ISLN病理未缓解（HR=0.25，95%CI=0.10-0.62，P<0.01）与预后不良相关。K-M曲线分析显示，血小板计数高的患者预后比血小板计数低的患者差（HR=5.32，95%CI=2.41-11.75，P<0.01）。为进一步验证该结果的稳定性，多因素时间依赖性Cox模型也提示血小板水平较高与预后不良相关（HR=1.009，95%CI=1.003-1.016，P<0.01）。同时，绝经状态（HR=0.32，95%CI=0.14-0.76，P=0.01）和sPCR（HR=0.29，95%CI=0.12-0.70，P=0.01）也是DFS的独立预测因素。
血小板对ISLN转移的乳腺癌患者的预后具有重要的预测价值，这表明血小板计数可用于区分高危患者，从而获得临床益处。
