Lee Ok Hee, Min Sun-Young
Department of Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
Korean J Clin Oncol. 2020 Dec;16(2):79-88. doi: 10.14216/kjco.20013. Epub 2020 Dec 31.
Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) holds promise as a significant prognostic factor to predict NAC response in breast cancer patients. The absolute peripheral blood lymphocyte (PBL) count has been suggested as an independent predictor of response to NAC. The current study evaluated the relationship between pCR and the change of PBL count in patients treated with NAC.
A total of 61 patients with histologically confirmed breast cancer treated with NAC followed by mastectomy between January 2010 and December 2019 were analyzed retrospectively. Correlational analyses confirmed a statistically significant relationship between PBL count and pCR. Following conformational correlational analyses, patients were divided into two groups according to cutoff values using the receiver operating characteristics curve and a logistic regression was conducted to determine the optimal conditions for achieving pCR.
A total of 14 patients (22.9%) achieved pCR. Most PBL counts decreased after NAC relevant to pCR. Logistic regression analysis revealed that a small decrease of PBL was associated with pCR (P=0.028). The cutoff value of PBL decrease was 755×10/L, which was used to divide patients into high and low reduction groups. The pCR rate was 11.43% and 38.46% for the high and low reduction group, respectively (area under the curve, 0.707; 95% confidence interval, 0.556-0.858; P=0.020). The high reduction group was found to have more difficulty achieving pCR.
The decrease of PBL is significantly associated with pCR. Our data support that the decrease of PBL after NAC may be useful factors in predicting the response to NAC in breast cancer patients.
新辅助化疗（NAC）后的病理完全缓解（pCR）有望成为预测乳腺癌患者NAC反应的重要预后因素。外周血淋巴细胞（PBL）绝对计数已被认为是NAC反应的独立预测指标。本研究评估了接受NAC治疗的患者中pCR与PBL计数变化之间的关系。
回顾性分析了2010年1月至2019年12月期间61例经组织学确诊的乳腺癌患者，这些患者接受了NAC治疗，随后进行了乳房切除术。相关性分析证实PBL计数与pCR之间存在统计学上的显著关系。在进行构象相关性分析后，使用受试者工作特征曲线根据临界值将患者分为两组，并进行逻辑回归以确定实现pCR的最佳条件。
共有14例患者（22.9%）实现了pCR。与pCR相关的是，大多数患者NAC后PBL计数下降。逻辑回归分析显示，PBL的小幅下降与pCR相关（P=0.028）。PBL下降的临界值为755×10/L，用于将患者分为高降低组和低降低组。高降低组和低降低组的pCR率分别为11.43%和38.46%（曲线下面积，0.707；95%置信区间，0.556-0.858；P=0.020）。发现高降低组实现pCR更困难。
PBL的下降与pCR显著相关。我们的数据支持NAC后PBL的下降可能是预测乳腺癌患者对NAC反应的有用因素。
