Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No:47, 34865, Kartal, Istanbul, Turkey.
Division of Medical Oncology, School of Medicine, Koç University, Istanbul, Turkey.
Sci Rep. 2024 May 27;14(1):12123. doi: 10.1038/s41598-024-63096-7.
Neoadjuvant chemotherapy (NACT) is the standard treatment for locally advanced, high-risk breast cancer. Pathological complete response (pCR) improves survival. Peripheral blood-derived indices reflecting systemic inflammation and nutritional status have long been used as predictive and prognostic markers in solid malignancies. This retrospective study investigates whether eight commonly used indices in patients receiving NACT affect pCR and survival. This study includes 624 locally advanced breast cancer patients who received NACT. The biomarker indices were calculated from peripheral blood samples taken two weeks before starting chemotherapy. The indices' optimal cut-off values were determined using ROC Curve analysis. During a median follow-up period of 42 months, recurrence was detected in 146 patients, and 75 patients died. pCR was observed in 166 patients (26.6%). In univariate analysis, NLR, PLR, SII, PNI, HALP, and HRR were statistically significantly associated (p = 0.00; p = 0.03; p = 0.03; p = 0.02; p = 0.00; p = 0.02 respectively), but in multivariate analysis, only NLR was significantly predictive for pCR(p = 0.04). In multivariate analysis, the HGB/RDW score significantly predicted DFS(p = 0.04). The PNI score was identified as a marker predicting survival for both OS and PFS (p = 0.01, p = 0.01, respectively). In conclusion, peripheral blood-derived indices have prognostic and predictive values on pCR and survival. However, further studies are needed to validate our findings.
新辅助化疗（NACT）是局部晚期、高危乳腺癌的标准治疗方法。病理完全缓解（pCR）可改善生存。外周血衍生的反映全身炎症和营养状况的指标长期以来一直被用作实体恶性肿瘤的预测和预后标志物。本回顾性研究调查了接受 NACT 的患者的 8 种常用指标是否影响 pCR 和生存。本研究纳入了 624 例接受 NACT 的局部晚期乳腺癌患者。在开始化疗前两周采集外周血样本计算生物标志物指数。使用 ROC 曲线分析确定最佳截断值。在中位随访 42 个月期间，146 例患者复发，75 例患者死亡。166 例患者（26.6%）观察到 pCR。单因素分析显示，NLR、PLR、SII、PNI、HALP 和 HRR 均有统计学意义（p = 0.00；p = 0.03；p = 0.03；p = 0.02；p = 0.00；p = 0.02 分别），但多因素分析显示，仅 NLR 对 pCR 有显著预测作用（p = 0.04）。多因素分析显示，HGB/RDW 评分显著预测 DFS（p = 0.04）。PNI 评分是预测 OS 和 PFS 生存的标志物（p = 0.01，p = 0.01）。总之，外周血衍生的指标对 pCR 和生存具有预后和预测价值。然而，需要进一步的研究来验证我们的发现。
