血清中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及血清白蛋白与淋巴细胞比值与三阴性乳腺癌新辅助化疗疗效及预后的相关性
Correlation of serum NLR, PLR and HALP with efficacy of neoadjuvant chemotherapy and prognosis of triple-negative breast cancer.
作者信息
Lou Caiyu, Jin Fenyuan, Zhao Qiang, Qi Hongming
机构信息
Department of Obstetrics and Gynecology, The Sixth People's Hospital of Zhuji Zhuji 311800, Zhejiang Province, China.
Department of Obstetrics and Gynecology, The People's Hospital of Zhuji Zhuji 311800, Zhejiang Province, China.
出版信息
Am J Transl Res. 2022 May 15;14(5):3240-3246. eCollection 2022.
OBJECTIVE
To investigate the correlation of blood neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) with the efficacy of neoadjuvant chemotherapy (NAC) and the prognosis of triple-negative breast cancer (TNBC).
METHODS
In this retrospective study, clinical data of 92 patients with TNBC were analyzed. The patients were treated with NAC in the Department of Gynecology of the People's Hospital of Zhuji from January 2015 to December 2018. According to treatment efficacy of NAC, patients were divided into a pathologic complete response (pCR) group (n=37) and a non-pathologic complete response (non-pCR) group (n=55). The pathological and clinical data of patients were collected, and the efficacy of NAC and influencing factors were statistically analyzed. The predicting performances of NLR, PLR and HALP for the efficacy of NAC in patients with TNBC were investigated. Patients were followed up for 3 years to obtain the all-cause mortality so as to analyze the correlation of NLR, PLR and HALP with survival time.
RESULTS
Multivariate regression analysis showed that TNM stage III (OR (95% CI): 1.742 (1.209-2.631), P=0.003), lymph nodes metastasis (OR (95% CI): 1.922 (1.492-2.983), P =0.005), high NLR (OR (95% CI): 2.261 (1.625-2.754), P<0.001), high PLR (OR (95% CI): 2.062 (1.692-2.791), P<0.001) and low HALP (OR (95% CI): 0.518 (0.365-0.734), P<0.001) were risk factors of poor NAC efficacy for TNBC. The mortality of patients in the non-pCR group was higher than that in the pCR group within 3 years (P<0.05). Survival analysis showed that the 3-year survival rate of the non-pCR group was lower than that of the pCR group (P<0.05). Furthermore, patients with high NLR, high PLR and low HALP had a lower 3-year survival rate than those with low NLR, low PLR and high HALP (P<0.05).
CONCLUSIONS
Lymph node metastasis, TNM stage III, high NLR, high PLR and low HALP are risk factors for the poor efficacy of NAC for TNBC. High expression of NLR, PLR and low expression of HALP may indicate a poor prognosis of TNBC patients who failed NAC.
目的
探讨血中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及血红蛋白和白蛋白水平与淋巴细胞及血小板计数（HALP）与新辅助化疗（NAC）疗效及三阴性乳腺癌（TNBC）预后的相关性。
方法
本回顾性研究分析了92例TNBC患者的临床资料。这些患者于2015年1月至2018年12月在诸暨市人民医院妇科接受NAC治疗。根据NAC治疗疗效，将患者分为病理完全缓解（pCR）组（n = 37）和非病理完全缓解（non-pCR）组（n = 55）。收集患者的病理和临床资料，对NAC疗效及影响因素进行统计学分析。研究NLR、PLR和HALP对TNBC患者NAC疗效的预测性能。对患者进行3年随访以获取全因死亡率，从而分析NLR、PLR和HALP与生存时间的相关性。
结果
多因素回归分析显示，TNMⅢ期（OR（95%CI）：1.742（1.209 - 2.631），P = 0.003）、淋巴结转移（OR（95%CI）：1.922（1.492 - 2.983），P = 0.005）、高NLR（OR（95%CI）：2.261（1.625 - 2.754），P < 0.001）、高PLR（OR（95%CI）：2.062（1.692 - 2.791），P < 0.001）和低HALP（OR（95%CI）：0.518（0.365 - 0.734），P < 0.001）是TNBC患者NAC疗效差的危险因素。non-pCR组患者3年内死亡率高于pCR组（P < 0.05）。生存分析显示，non-pCR组3年生存率低于pCR组（P < 0.05）。此外，NLR高、PLR高和HALP低的患者3年生存率低于NLR低、PLR低和HALP高的患者（P < 0.05）。
结论
淋巴结转移、TNMⅢ期、高NLR、高PLR和低HALP是TNBC患者NAC疗效差的危险因素。NLR、PLR高表达及HALP低表达可能提示NAC治疗失败的TNBC患者预后不良。
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