Chen Xiaobin, Cai Qindong, Deng Lin, Chen Minyan, Xu Min, Chen Lili, Lin Yuxiang, Li Yan, Wang Yali, Chen Hanxi, Liu Shunyi, Wu Jinqiao, Tong Xin, Fu Fangmeng, Wang Chuan
Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Front Immunol. 2024 Nov 19;15:1465862. doi: 10.3389/fimmu.2024.1465862. eCollection 2024.
The association between inflammatory blood markers (IBMs) (monocyte-to-lymphocyte ratio [MLR], neutrophil-to-lymphocyte ratio [NLR], and platelet-to-lymphocyte ratio [PLR]) and breast cancer has been extensively studied. However, the predictive role of IBMs in the neoadjuvant response of human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains unclear.
This study included 744 patients with HER2 positive breast cancer treated with neoadjuvant therapy. Baseline MLR, NLR, and PLR data were collected to investigate the association between IBMs and pathological complete response (pCR).
MLR, NLR, and PLR were not associated with neoadjuvant response in the overall population before and after matching. Subgroup analysis stratified by neoadjuvant therapy suggested that these IBMs play a diverse predictive role in response to chemotherapy alone and chemotherapy plus anti-HER2 therapy. A high MLR and NLR, but not PLR, were associated with lower pCR rates in HER2-targeted therapy (MLR: OR=0.67, =0.023; NLR: OR=0.665, =0.02; PLR: OR=0.801, =0.203). Among the anti-HER2 treatment population, patients with a high MLRs (pCR rate, 40.2%) could be divided into MLR/NLR (pCR rate, 36.3%) and MLR/NLR (pCR rate, 48.9%) groups when the NLR was considered. The pCR rates of the MLR/NLR and low-MLR groups were similar (pCR rate, 47.6%). A comparable stratification effect was observed in patients with high NLR.
IBMs play a diverse predictive role in pCR in HER2-positive breast cancer stratified by neoadjuvant regimens. The combination of high MLR and high NLR enabled better identification of patients with poor responses to anti-HER2 therapy than high MLR or NLR alone.
炎症性血液标志物（IBM）（单核细胞与淋巴细胞比值[MLR]、中性粒细胞与淋巴细胞比值[NLR]和血小板与淋巴细胞比值[PLR]）与乳腺癌之间的关联已得到广泛研究。然而，IBM在人表皮生长因子受体2（HER2）阳性乳腺癌新辅助治疗反应中的预测作用仍不清楚。
本研究纳入了744例接受新辅助治疗的HER2阳性乳腺癌患者。收集基线MLR、NLR和PLR数据，以研究IBM与病理完全缓解（pCR）之间的关联。
匹配前后的总体人群中，MLR、NLR和PLR与新辅助治疗反应均无关联。按新辅助治疗分层的亚组分析表明，这些IBM在单纯化疗和化疗加抗HER2治疗的反应中发挥不同的预测作用。在HER2靶向治疗中，高MLR和高NLR（而非PLR）与较低的pCR率相关（MLR：OR = 0.67，P = 0.023；NLR：OR = 0.665，P = 0.02；PLR：OR = 0.801，P = 0.203）。在抗HER2治疗人群中，当考虑NLR时，高MLR患者（pCR率为40.2%）可分为高MLR/高NLR组（pCR率为36.3%）和高MLR/低NLR组（pCR率为48.9%）。高MLR/低NLR组和低MLR组的pCR率相似（pCR率为47.6%）。在高NLR患者中观察到类似的分层效应。
IBM在按新辅助方案分层的HER2阳性乳腺癌pCR中发挥不同的预测作用。与单独的高MLR或高NLR相比，高MLR和高NLR的组合能够更好地识别对抗HER2治疗反应不佳的患者。
