术前中性粒细胞与淋巴细胞比值和男性乳腺癌预后的关系

Relationship of preoperative neutrophil to lymphocyte ratio with prognosis of male breast cancer

目的:探讨术前中性粒细胞与淋巴细胞比值(NLR)和男性乳腺癌预后的关系。方法:回顾性分析郑州大学第一附属医院2013年1月至2019年9月收治的62例男性乳腺癌患者的临床和随访资料。采用ROC曲线确定NLR分组的界值,据此将患者分为低NLR组(n=41)与高NLR组(n=21),分析2组患者临床病理特征的差异。采用Kaplan-Meier法绘制2组患者的生存曲线,Log-rank检验比较2组患者生存曲线的差异,并采用Cox比例风险回归模型分析NLR对男性乳腺癌预后的影响。结果:根据ROC曲线,确定NLR分组的界值为2.37。与低NLR组相比,高NLR组患者肿瘤直径>50 mm者、淋巴结转移者及临床分期Ⅲ期者所占比例更高(P<0.05);高、低NLR组生存曲线差异有统计学意义(P<0.001),低NLR组预后优于高NLR组。NLR(HR=3.183,95%CI为1.019~9.947)和肿瘤直径(HR=6.085,95%CI为1.634~22.656)是患者预后的影响因素。结论:术前NLR可作为评估男性乳腺癌预后的参考指标。

Aim:To investigate the relationship of preoperative neutrophil to lymphocyte ratio(NLR)with the prognosis of male breast cancer.Methods:A total of 62 male breast cancer patients who were treated in the First Affiliated Hospital,Zhengzhou University from January 2013 to September 2019 were retrospectively enrolled.The ROC curve was used to determine the cut-off value of NLR,and the patients were allocated into low NLR group(41 patients)and high NLR group(21 patients)accordingly to analyze differences in clinicopathological characteristics of patients with different NLR levels.The Kaplan-Meier method was used to plot survival curves of the two NLR groups,and the Log-rank test was used to compare the difference in survival curves between the 2 groups.Cox proportional hazards regression model was performed to analyze the influence of NLR on the prognosis of the patients.Results:According to the ROC curve,the cut-off value of NLR was 2.37.Compared with low NLR group,patients in high NLR group had a higher proportion of tumor size>50 mm,lymph node metastasis and clinical stageⅢ(P<0.05).There was a difference in survival curves between different NLR groups(P<0.001),the prognosis of low NLR group was better than that of high NLR group.Preoperative NLR[HR 3.183,95%CI 1.019-9.947]and tumor size[HR 6.085,95%CI 1.634-22.656]were independent factors influencing the prognosis of the patients.Conclusion:Preoperative NLR could be used as an important prognostic indicator for male breast cancer.