Huang Qiuyan, Huang Kai, Qian Jinxian, Yang Yinlong
Department of Breast Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China.
Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Ther Adv Med Oncol. 2025 Sep 26;17:17588359251369041. doi: 10.1177/17588359251369041. eCollection 2025.
Taxane-carboplatin-based neoadjuvant chemotherapy (NAC) improves the pathological complete response (pCR) rate in human epidermal growth factor receptor 2 (HER2)-negative breast cancer. However, its effect on long-term survival remains unclear. Reliable prognostic biomarkers are needed to guide personalized postoperative strategies.
To evaluate the prognostic significance of the platelet-to-lymphocyte ratio (PLR) and to construct a predictive model for overall survival (OS) in this clinical setting.
This was a retrospective, multicenter cohort study involving an internal development cohort and an external validation cohort.
We retrospectively analyzed 178 HER2-negative breast cancer patients treated with taxane-carboplatin NAC at Fudan University Shanghai Cancer Center (FUSCC). The optimal PLR cutoff (129.75) was identified via receiver operating characteristic (ROC) analysis. Logistic regression assessed the association between PLR and pCR, and multivariate Cox regression evaluated its prognostic value for OS. A nomogram incorporating PLR, estrogen receptor (ER) status, and clinical stage was built using the FUSCC cohort. The nomogram was externally validated in 34 patients from Fujian Cancer Hospital.
Among the 178 patients, 94 (52.8%) had high PLR and 84 (47.2%) had low PLR. High PLR was not independently associated with pCR (odds ratio = 1.006; 95% confidence interval (CI): 0.999-1.013; = 0.079). However, in non-pCR patients, high PLR was significantly linked to poorer OS ( = 0.001). Multivariate analysis identified high PLR (hazard ratio = 5.718; 95% CI: 1.664-19.646; = 0.006), clinical stage III disease, and ER positivity as independent OS predictors. The nomogram integrating these factors demonstrated strong predictive performance in both cohorts.
This is the first study to evaluate PLR as a prognostic marker in HER2-negative breast cancer treated with taxane-carboplatin NAC. High PLR was independently associated with poorer survival. The proposed nomogram provides a practical tool for postoperative risk stratification and personalized care.
基于紫杉烷-卡铂的新辅助化疗（NAC）可提高人表皮生长因子受体2（HER2）阴性乳腺癌的病理完全缓解（pCR）率。然而，其对长期生存的影响仍不明确。需要可靠的预后生物标志物来指导个性化的术后策略。
评估血小板与淋巴细胞比值（PLR）的预后意义，并构建该临床环境下总生存（OS）的预测模型。
这是一项回顾性多中心队列研究，包括一个内部开发队列和一个外部验证队列。
我们回顾性分析了复旦大学附属肿瘤医院（FUSCC）178例接受紫杉烷-卡铂NAC治疗的HER2阴性乳腺癌患者。通过受试者工作特征（ROC）分析确定最佳PLR临界值（129.75）。逻辑回归评估PLR与pCR之间的关联，多变量Cox回归评估其对OS的预后价值。使用FUSCC队列构建了一个包含PLR、雌激素受体（ER）状态和临床分期的列线图。该列线图在福建医科大学附属肿瘤医院的34例患者中进行了外部验证。
178例患者中，94例（52.8%）PLR高，84例（47.2%）PLR低。高PLR与pCR无独立相关性（比值比=1.006；95%置信区间（CI）：0.999-1.013；P=0.079）。然而，在非pCR患者中，高PLR与较差的OS显著相关（P=0.001）。多变量分析确定高PLR（风险比=5.718；95%CI：1.664-19.646；P=0.006）、临床III期疾病和ER阳性为独立的OS预测因素。整合这些因素的列线图在两个队列中均显示出强大的预测性能。
这是第一项评估PLR作为接受紫杉烷-卡铂NAC治疗的HER2阴性乳腺癌预后标志物的研究。高PLR与较差的生存率独立相关。所提出的列线图为术后风险分层和个性化护理提供了一个实用工具。
