摘要
目的评价乳腺癌患者新辅助化疗前外周血血小板与淋巴细胞比率(PLR)与病理完全缓解(pCR)的关系。方法回顾性分析2013年1月至2018年6月期间在郑州大学第一附属医院确诊并接受新辅助化疗的242例乳腺癌患者的临床资料。将约登指数最大值对应的PLR值作为截断值,按照>截断值和≤截断值分为高PLR组、低PLR组。采用χ2检验及Logistic回归模型分析乳腺癌患者治疗前外周血PLR水平与其是否达到pCR的关系。结果约登指数最大值对应的PLR为146.7,以之为截断值,将患者分为高PLR(>146.7)组48例和低PLR(≤146.7)组194例。本研究中,90例(37.2%)患者达到pCR,缓解率最高的分子分型是三阴性46例(65.7%)及Her-2扩增型18例(33.3%)。χ2检验分析表明,组织学分级、雌激素受体状态、孕激素受体状态、分子分型以及患者PLR都与乳腺癌患者新辅助化疗后是否达到pCR显著相关。Logistic回归分析模型表明,组织学分级、分子分型及PLR与乳腺癌患者新辅助化疗后是否达到pCR显著相关,低PLR组乳腺癌患者新辅助化疗后pCR率显著高于高PLR组患者(OR=0.450,95%CI=0.204~0.995,P=0.048)。结论PLR是乳腺癌患者新辅助化疗后是否达到pCR的独立预测因素,其可作为预测乳腺癌预后的有效指标。
Objective To assess the relationship between peripheral blood platelet-to-lymphocyte ratio(PLR)andpathologic complete response(pCR)in the breast cancer treated with neoadjuvant chemotherapy.Methods Theclinical data of 242 patients with breast cancer diagnosed and accepted neoadjuvant chemotherapyretrospectively analyzedin the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2018.The PLR value corresponding to the maximum value of Yoden index was regarded as cutoff value,and the patients was divided into high and low ratio groups according to the cutoff value.Chi-square test and logistic regression model were used to analyze the relationship between PLR level in peripheral blood and pCR level before neoadjuvant chemotherapy in the patients with breast cancer.Results The PLR value corresponding to the maximum of Yoden index was 146.7,regarded as cutoff values.And there were 48 patients in the high PLR group(>146.7)and 194 patients in the low PLR group(≤146.7).In this study,90 patients(37.2%)achieved pCR.The highest pCR rate was found in 46 patients(65.7%)with triple negative and 18 patients(33.3%)with Her-2 enriched.Chi-square test analysis showed that tumor grade,estrogen receptor status,progesteronereceptor status,biological subtype and PLR value were significantly correlated with pCR in the patients with breast cancer after neoadjuvant chemotherapy.Logistic regression analysis model showed that tumor grade,biological subtype and PLR value were significantly correlated with pCR in the patients with breast cancer after neoadjuvant chemotherapy.The pCR rate of patients with breast cancer after neoadjuvant chemotherapy in the low PLR group was significantly higher than that in the high PLR group(OR=0.450,95%CI=0.204-0.995,P=0.048).Conclusion PLR is an independent predictor of whether patients with breast cancer achieve pCR after neoadjuvant chemotherapy,and it can be used as an effective prognostic indicator of breast cancer.
作者
曲幽
杜闯
李靖若
QU You;DU Chuang;LI Jingruo(Department of Breast Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《肿瘤基础与临床》
2019年第6期505-510,共6页
journal of basic and clinical oncology
关键词
乳腺癌
新辅助化疗
血小板/淋巴细胞比值
病理完全缓解
预后
breast cancer
neoadjuvant chemotherapy
platelet-to-lymphocyte ratio
pathologic complete response
prognosis
作者简介
曲幽(1993-),女,硕士在读,主要从事乳腺癌基础与临床研究。E-mail:407838271@qq.com;通信作者:李靖若(1968-),女,博士,主任医师,主要从事乳腺癌基础与临床研究。E-mail:jingruoli@163.com。
