Guo Qian, Wang Bingping, Gao Xinran, Zhao Pu, Lv Shuang
Department of Breast Surgical Oncology, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia Autonomous Region 010017, P.R. China.
Department of Medical Oncology, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia Autonomous Region 010017, P.R. China.
Oncol Lett. 2025 Mar 27;29(5):252. doi: 10.3892/ol.2025.14998. eCollection 2025 May.
Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer with limited targeted treatment options, making the identification of reliable prognostic markers crucial for improving patient outcomes. The present study aimed to assess the predictive ability of pre-chemotherapy and pre-surgery inflammatory status on the prognosis of patients with TNBC undergoing neoadjuvant therapy. A total of 422 patients with TNBC who received neoadjuvant chemotherapy at the Inner Mongolia People's Hospital between January 2017 and December 2022 were selected for analysis. Fasting venous blood samples were collected 1 day prior to chemotherapy and 1 day prior to surgery to assess and calculate inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI). The optimal cut-off values of the inflammatory markers were determined using receiver operating characteristic curves. Survival analysis was used to evaluate the differences in survival and significant prognostic factors. Propensity score matching (PSM) analysis was performed to further asses the prognostic value of the relevant factors. Survival analysis indicated that patients with high pre-chemotherapy and pre-surgery NLR, PLR, SII and SIRI scores exhibited shorter overall survival (OS) rates compared with those with low scores (all P<0.05). Multivariate analysis revealed that tumor-node-metastasis stage, pathological complete response and pre-surgery SII were independent prognostic factors for OS. Following PSM, the area under the curve for SII was 0.642 and patients with high SII scores exhibited shorter OS rates than those with low scores (χ=8.452; P=0.004). Therefore, these results indicated that both pre-chemotherapy and pre-surgery inflammatory statuses are associated with the OS of patients with TNBC undergoing neoadjuvant chemotherapy, notably pre-surgery SII.
三阴性乳腺癌（TNBC）是一种侵袭性很强的乳腺癌亚型，靶向治疗选择有限，因此确定可靠的预后标志物对于改善患者预后至关重要。本研究旨在评估化疗前和手术前炎症状态对接受新辅助治疗的TNBC患者预后的预测能力。选取2017年1月至2022年12月期间在内蒙古自治区人民医院接受新辅助化疗的422例TNBC患者进行分析。在化疗前1天和手术前1天采集空腹静脉血样本，以评估和计算炎症标志物，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）。使用受试者工作特征曲线确定炎症标志物的最佳临界值。采用生存分析评估生存率差异和显著的预后因素。进行倾向评分匹配（PSM）分析以进一步评估相关因素的预后价值。生存分析表明，化疗前和手术前NLR、PLR、SII和SIRI评分高的患者与评分低的患者相比，总生存期（OS）较短（所有P<0.05）。多因素分析显示，肿瘤-淋巴结-转移分期、病理完全缓解和手术前SII是OS的独立预后因素。PSM后，SII的曲线下面积为0.642，SII评分高的患者的OS率低于评分低的患者（χ=8.452；P=0.004）。因此，这些结果表明，化疗前和手术前的炎症状态均与接受新辅助化疗的TNBC患者的OS相关，尤其是手术前SII。
