中性粒细胞与淋巴细胞比值在局部晚期乳腺癌中的预后意义
Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer.
作者信息
Alshamsan Bader, Elshenawy Mahmoud A, Aseafan Mohamed, Fahmy Nermin, Badran Ahmed, Elhassan Tusneem, Alsayed Adher, Suleman Kausar, Al-Tweigeri Taher
机构信息
Department of Medicine, College of Medicine, Qassim University, Buraydah, Qassim 52571, Kingdom of Saudi Arabia.
Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Kingdom of Saudi Arabia.
出版信息
Oncol Lett. 2024 Jul 11;28(3):429. doi: 10.3892/ol.2024.14562. eCollection 2024 Sep.
The present study aimed to clarify the prognostic role of the pre-treatment neutrophil-to-lymphocyte ratio (NLR) for the response to neoadjuvant chemotherapy (NAC) in locally advanced breast cancer (LABC). Due to conflicting results in currently available data, the specific focus of the present study was on evaluating the associations between the pre-treatment NLR and the rate of achieving a pathological complete response (pCR) and survival outcomes. For the present study, data from a cohort of 465 consecutive patients with LABC who underwent NAC at King Feisal Specialist Hospital and Research Center (Riyadh, Saudi Arabia) between 2005 and 2014 were obtained from a prospective BC database and analyzed. Patients were stratified into two groups based on an optimal NLR cut-off determined using the receiver operating characteristic curve. Logistic regression analyses were conducted to assess variables associated with pCR, and Cox regression analyses were used to assess variables associated with survival outcomes. The low pre-treatment NLR group (≤2.2) was found to exhibit a higher likelihood of achieving a pCR (odds ratio, 2.59; 95% CI, 1.52-4.38; P<0.001), along with higher 5-year disease-free survival (DFS) [75.8 vs. 64.9%; hazard ratio (HR), 0.69; 95% CI, 0.50-0.94; P=0.02] and 5-year overall survival (OS; 90.3 vs. 81.9; HR, 0.62; 95% CI, 0.39-0.98; P=0.04) rates compared with those in the high NLR group (>2.2). Sub-group analysis revealed that the observed significance in survival outcomes was driven by the triple-negative BC (TNBC) subgroup. Patients with residual TNBC disease and a high pre-treatment NLR were observed to have lower 5-year DFS (44.4 vs. 75.0%; P=0.02) and 5-year OS (55.9 vs. 84.5%; P=0.055) rates compared with those with residual TNBC disease and a low NLR. To conclude, data from the present study suggest that the pre-treatment NLR can serve as a viable independent prognostic factor for pCR following NAC in patients with LABC and for survival outcomes, particularly for patients with TNBC.
本研究旨在阐明治疗前中性粒细胞与淋巴细胞比值（NLR）对局部晚期乳腺癌（LABC）新辅助化疗（NAC）反应的预后作用。由于现有数据结果相互矛盾，本研究的具体重点是评估治疗前NLR与病理完全缓解（pCR）率及生存结果之间的关联。对于本研究，从一个前瞻性乳腺癌数据库中获取了2005年至2014年期间在费萨尔国王专科医院和研究中心（沙特阿拉伯利雅得）接受NAC的465例连续LABC患者队列的数据，并进行了分析。根据使用受试者工作特征曲线确定的最佳NLR临界值，将患者分为两组。进行逻辑回归分析以评估与pCR相关的变量，并使用Cox回归分析评估与生存结果相关的变量。结果发现，治疗前NLR低的组（≤2.2）实现pCR的可能性更高（优势比，2.59；95%可信区间，1.52 - 4.38；P<0.001），5年无病生存率（DFS）也更高[75.8%对64.9%；风险比（HR），0.69；95%可信区间，0.50 - 0.94；P = 0.02]，5年总生存率（OS；90.3%对81.9%；HR，0.62；95%可信区间，0.39 - 0.98；P = 0.04）也高于NLR高的组（>2.2）。亚组分析显示，生存结果的显著差异是由三阴性乳腺癌（TNBC）亚组驱动的。与残留TNBC疾病且治疗前NLR低的患者相比，残留TNBC疾病且治疗前NLR高的患者5年DFS（44.4%对75.0%；P = 0.02）和5年OS（55.9%对84.5%；P = 0.055）率更低。总之，本研究数据表明，治疗前NLR可作为LABC患者NAC后pCR及生存结果的一个可行的独立预后因素，特别是对于TNBC患者。
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