预处理全身炎症反应指数可预测接受新辅助化疗的乳腺癌患者的病理完全缓解。
Pretreatment systemic inflammation response index is predictive of pathological complete response in patients with breast cancer receiving neoadjuvant chemotherapy.
机构信息
Department of Medical Oncology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, 2300001, Anhui Province, China.
Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui Province, China.
出版信息
BMC Cancer. 2021 Jun 14;21(1):700. doi: 10.1186/s12885-021-08458-4.
BACKGROUND
Inflammation plays an important role in tumor proliferation, metastasis, and resistance to chemotherapy. The systemic inflammation response index (SIRI), has been reported to be closely related to prognosis in many tumors, such as breast and gastric cancers. However, the predictive value of pretreatment SIRI on pathological complete response (pCR) rates in patients with breast cancer treated with neoadjuvant chemotherapy (NAC) is unknown. This study examined the correlation between SIRI and pCR in patients with breast cancer receiving NAC and identified convenient and accurate predictive indicators for pCR.
METHODS
We retrospectively analyzed the clinicopathological parameters and pretreatment peripheral blood characteristics of the 241 patients with breast cancer who received NAC between June 2015 and June 2020. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff of SIRI. ROC curves were also plotted to verify the accuracy of inflammatory markers for pCR prediction. The chi-squared test was used to explore the relationships of SIRI with pCR and other clinicopathological parameters. Multivariate analyses were performed using a logistic regression model.
RESULTS
Among the 241 patients, 48 (19.92%) achieved pCR. pCR was significantly related to SIRI, the neutrophil-lymphocyte ratio (NLR), the lymphocyte-monocyte ratio (LMR), molecular subtypes and other clinicopathological parameters, such as BMI, clinical T and N staging, and histological grade. Multivariate analyses indicated that the clinical T and N staging, SIRI, and NLR were independent prognostic factors for pCR in patients with breast cancer. The area under the ROC curve for SIRI was larger than that for NLR. Compared to patients with SIRI ≥0.72, patients with SIRI < 0.72 had a nearly 5-fold higher chance of obtaining pCR (odds ratio = 4.999, 95% confidence interval = 1.510-16.551, p = 0.000).
CONCLUSIONS
Pretreatment SIRI is predictive of pCR in patients with breast cancer receiving NAC, and the index can assist physicians in formulating personalized treatment strategies.
背景
炎症在肿瘤增殖、转移和化疗耐药中起着重要作用。全身性炎症反应指数（SIRI）已被报道与许多肿瘤（如乳腺癌和胃癌）的预后密切相关。然而，尚不清楚预处理 SIRI 对接受新辅助化疗（NAC）的乳腺癌患者的病理完全缓解（pCR）率的预测价值。本研究检测了 SIRI 与接受 NAC 的乳腺癌患者 pCR 之间的相关性，并确定了用于预测 pCR 的方便且准确的预测指标。
方法
我们回顾性分析了 2015 年 6 月至 2020 年 6 月期间接受 NAC 的 241 例乳腺癌患者的临床病理参数和外周血特征。采用受试者工作特征（ROC）曲线确定 SIRI 的最佳截断值。绘制 ROC 曲线以验证炎症标志物预测 pCR 的准确性。采用卡方检验探讨 SIRI 与 pCR 及其他临床病理参数的关系。采用逻辑回归模型进行多变量分析。
结果
在 241 例患者中，48 例（19.92%）达到 pCR。pCR 与 SIRI、中性粒细胞-淋巴细胞比值（NLR）、淋巴细胞-单核细胞比值（LMR）、分子亚型和其他临床病理参数（如 BMI、临床 T 和 N 分期以及组织学分级）显著相关。多变量分析表明，临床 T 和 N 分期、SIRI 和 NLR 是乳腺癌患者 pCR 的独立预后因素。SIRI 的 ROC 曲线下面积大于 NLR。与 SIRI≥0.72 的患者相比，SIRI<0.72 的患者获得 pCR 的几率几乎高 5 倍（比值比=4.999，95%置信区间=1.510-16.551，p=0.000）。
结论
预处理 SIRI 可预测接受 NAC 的乳腺癌患者的 pCR，该指标可帮助医生制定个体化治疗策略。
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