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中性粒细胞与淋巴细胞比值及基质肿瘤浸润淋巴细胞在新辅助化疗治疗局部晚期三阴性乳腺癌中的预后作用及其关系

Prognostic Roles of Neutrophil-to-Lymphocyte Ratio and Stromal Tumor-Infiltrating Lymphocytes and Their Relationship in Locally Advanced Triple-Negative Breast Cancer Treated with Neoadjuvant Chemotherapy.

作者信息

Dong Xue, Liu Congfang, Yuan Jiaqi, Wang Shouman, Ding Nianhua, Li Yong, Wu Yuhui, Xiao Zhi

机构信息

Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China.

Clinical Research Center for Breast Cancer Control and Prevention in Human Province, Changsha, China.

出版信息

Breast Care (Basel). 2021 Aug;16(4):328-334. doi: 10.1159/000509498. Epub 2020 Sep 4.

Abstract

INTRODUCTION

The neutrophil-to-lymphocyte ratio (NLR) and stromal tumor-infiltrating lymphocytes (sTILs) are associated with immunogenicity and prognosis of patients with triple-negative breast cancer (TNBC).

OBJECTIVE

To investigated the prognostic roles of NLR and sTILs and their rela-tionship of TNBC patients treated with neoadjuvant chemotherapy (NAC).

METHODS

The clinical data of 170 patients with locally advanced TNBC who received NAC from January 2010 to December 2014 were collected. The difference among variables was calculated by χ test. The association between essential clinicopathological characteristics, pathological complete response (pCR), NLR, and sTILs with disease-free survival (DFS) was analyzed. Kaplan-Meier and Cox analysis were performed to address the effects of clinical parameters on prognosis.

RESULTS

There was a trend that TNBC patients with lower baseline NLR (NLR1) or higher sTILs scoring would obtain a better pCR rate. NLR1 and sTILs were not associated ( > 0.05). Patients with low NLR1 or high sTILs scoring had a significantly improved DFS compared to those with high NLR1 or low sTILs scoring ( = 0.002 and = 0.001, respectively). The increased lymphocyte count in peripheral blood after NAC was associated with the improved DFS outcome in both high and low NLR1 groups. Cox analysis revealed that NLR1 and sTILs were independent prognostic predictors of DFS outcome ( < 0.001).

CONCLUSION

Low NLR1 and high sTILs were associated with better DFS outcome in locally advanced TNBC patients treated with NAC. Further studies are needed to explore the connection between systemic and local inflammatory/immune markers.

摘要

引言

中性粒细胞与淋巴细胞比值(NLR)和基质肿瘤浸润淋巴细胞(sTILs)与三阴性乳腺癌(TNBC)患者的免疫原性及预后相关。

目的

探讨NLR和sTILs在接受新辅助化疗(NAC)的TNBC患者中的预后作用及其相互关系。

方法

收集2010年1月至2014年12月期间接受NAC的170例局部晚期TNBC患者的临床资料。采用χ²检验计算变量间差异。分析基本临床病理特征、病理完全缓解(pCR)、NLR和sTILs与无病生存期(DFS)之间的关联。进行Kaplan-Meier分析和Cox分析以探讨临床参数对预后的影响。

结果

基线NLR较低(NLR1)或sTILs评分较高的TNBC患者有获得更好pCR率的趋势。NLR1与sTILs无相关性(P>0.05)。与NLR1高或sTILs评分低的患者相比,NLR1低或sTILs评分高的患者DFS显著改善(分别为P = 0.002和P = 0.001)。NAC后外周血淋巴细胞计数增加与高NLR1组和低NLR1组的DFS改善结局均相关。Cox分析显示NLR1和sTILs是DFS结局的独立预后预测因素(P<0.001)。

结论

在接受NAC治疗的局部晚期TNBC患者中,低NLR1和高sTILs与更好的DFS结局相关。需要进一步研究探索全身和局部炎症/免疫标志物之间的联系。

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