Truffi Marta, Sottotetti Federico, Gafni Nadav, Albasini Sara, Piccotti Francesca, Morasso Carlo, Tibollo Valentina, Mocchi Michela, Zanella Valentina, Corsi Fabio
Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy.
Dipartimento di Scienze Biomediche e Cliniche, Università di Milano, 20157 Milano, Italy.
Cancers (Basel). 2022 Oct 27;14(21):5287. doi: 10.3390/cancers14215287.
Immune inflammatory biomarkers are easily obtained and inexpensive blood-based parameters that recently showed prognostic and predictive value in many solid tumors. In this study, we aimed to investigate the role of these biomarkers in predicting distant relapse in breast cancer patients treated with neoadjuvant chemotherapy (NACT). All breast cancer patients who referred to our Breast Unit and underwent NACT were retrospectively reviewed. The pre-treatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and pan-immune-inflammation value (PIV) were calculated from complete blood counts. The primary outcome was 5-year distant-metastasis-free survival (DMFS). In receiver operating characteristic analyses, the optimal cutoff values for the NLR, PLR, MLR, and PIV were determined at 2.25, 152.46, 0.25, and 438.68, respectively. High levels of the MLR, but not the NLR, PLR, or PIV, were associated with improved 5-year DMSF in the study population using both univariate (HR 0.52, = 0.03) and multivariate analyses (HR, 0.44; = 0.02). Our study showed that the MLR was a significant independent parameter affecting DMFS in breast cancer patients undergoing NACT. Prospective studies are required to confirm this finding and to define reliable cutoff values, thus leading the way for the clinical application of this biomarker.
免疫炎症生物标志物是易于获取且成本低廉的血液指标，最近在许多实体瘤中显示出预后和预测价值。在本研究中，我们旨在探讨这些生物标志物在预测接受新辅助化疗（NACT）的乳腺癌患者远处复发中的作用。对所有转诊至我们乳腺科并接受NACT的乳腺癌患者进行了回顾性研究。根据全血细胞计数计算治疗前的中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）以及全免疫炎症值（PIV）。主要结局是5年无远处转移生存期（DMFS）。在受试者工作特征分析中，NLR、PLR、MLR和PIV的最佳截断值分别确定为2.25、152.46、0.25和438.68。在研究人群中，无论是单因素分析（HR 0.52，P = 0.03）还是多因素分析（HR 0.44；P = 0.02），高水平的MLR而非NLR、PLR或PIV与改善的5年DMSF相关。我们的研究表明，MLR是影响接受NACT的乳腺癌患者DMFS的一个重要独立参数。需要进行前瞻性研究以证实这一发现并确定可靠的截断值，从而为该生物标志物的临床应用开辟道路。
