中性粒细胞与淋巴细胞比值在乳腺癌新辅助化疗中的意义

Significance of neutrophil to lymphocyte ratio in neoadjuvant chemotherapy for breast cancer

目的初步探究外周血中性粒细胞与淋巴细胞比值(NLR)的高低在乳腺癌新辅助化疗中的意义。方法回顾性分析59例行新辅助化疗的乳腺癌患者的临床资料,分析化疗前NLR值高低与临床特征及疗效的关系。结果乳腺癌患者化疗前的NLR值高低与患者的年龄、临床分期、肿瘤直径、组织学分级、雌激素受体(ER)表达情况、孕激素受体(PR)表达情况及美国东部肿瘤协作组(ECOG)评分无关(P﹥0.05)。NLR≤1.74的患者中,淋巴结转移数量﹥3、人类表皮生长因子受体2(HER2)阴性表达、Ki-67阴性表达的患者比例高于淋巴结转移数量≤3、HER2阳性表达、Ki-67阳性表达的患者比例,差异均有统计学意义(P﹤0.05)。NLR≤1.74的患者中,完全缓解占22.58%,部分缓解占51.61%,疾病稳定占22.58%,疾病进展占3.23%;而NLR﹥1.74的患者中,完全缓解占7.14%,部分缓解占35.71%,疾病稳定占46.43%,疾病进展占10.71%。NLR≤1.74患者的缓解率为74.19%,高于NLR﹥1.74患者的42.86%,差异有统计学意义(P﹤0.05)。结论 NLR可以作为乳腺癌患者新辅助化疗效果的重要预测指标。

Objective To investigate the value of neutrophil to lymphocyte ratio（NLR） in peripheral blood and its significance in neoadjuvant chemotherapy for breast cancer. Method The clinical data of 59 breast cancer patients with neoadjuvant chemotherapy were retrospectively analyzed, and the relationship between the peripheral blood NLR values before chemotherapy and the clinical characteristcs and therapeutic efficacy was analyzed. Result The NLR values of breast cancer patients before chemotherapy were not correlated with age, clinical stage, tumor diameter, histological grade, expression of estrogen receptor（ER）, expression of progesterone receptor（PR） and the Eastern Cooperative Oncology Group（ECOG） score（P〉0.05）. Among patients with NLR≤1.74, the proportion of patients with lymph node metastasis〉3, negative expression of human epidermal growth factor receptor 2（HER2） and negative expression of cell proliferation antigen Ki-67 were higher than the proportion of patients with lymph node metastasis≤3, positive expression of HER2 and positive expression of Ki-67（P〈0.05）. Among patients with NLR≤1.74, patients who were complete response accounted for 22.58%, partial response 51.61%, stable disease 22.58%, and progressive disease 3.23%. Among patients with NLR〉1.74, patients who were complete response accounted for 7.14%, partial response 35.71%, stable disease46.43%, progressive disease 10.71%. The response rate in patients with NLR≤1.74 was 74.19%, which was higher than that of 42.86% in patients with NLR〉1.74（P〈0.05）. Conclusion NLR can be used as an important indicator for predicting and evaluating the efficacy of neoadjuvant chemotherapy in breast cancer patients.