NLR、LMR与乳腺癌病理特征及预后的相关性

Correlations between NLR and LMR with Pathological Characteristics and Prognosis of Patients with Breast Cancer

目的探讨中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)与乳腺癌病理特征及预后的相关性。方法收集2016年10月—2020年3月手术治疗乳腺癌88例的临床资料。比较乳腺癌患者手术前后NLR、LMR水平。分析NLR、LMR与乳腺癌临床病理特征的关系。根据患者随访预后结果分组,采用多因素Cox比例风险模型分析影响乳腺癌患者预后的危险因素。结果乳腺癌患者手术后NLR明显低于手术前,LMR明显高于手术前(P<0.01)。根据手术前NLR和LMR的最佳临界值分为高NLR组(≥2.38)31例和低NLR组(<2.38)57例,高LMR组(≥5.46)33例和低LMR组(<5.46)55例。高NLR组与低NLR组、高LMR组与低LMR组的年龄、TNM分期、组织学分级、淋巴结转移、孕激素受体、雌激素受体、人表皮生长因子受体2、Ki-67表达情况等临床病理特征比较差异均无统计学意义(P>0.05)。TNM分期为Ⅲ~Ⅳ期、Ki-67高表达、高NLR、低LMR、术后未放疗或化疗是影响乳腺癌患者预后的独立危险因素(P<0.05,P<0.01)。结论NLR、LMR与乳腺癌临床病理特征无明显相关性,但与预后关系密切,NLR、LMR是预测乳腺癌患者预后的有效生物标志物。

Objective To investigate correlations between neutrophil-to-lymphocyte ratio(NLR)and lymphocyte-to-monocyte ratio(LMR)with pathological characteristics and prognosis of patients with breast cancer.Methods Clinical data of 88 patients with breast cancer who had been treated with surgery between October 2016 and March 2020 was collected.NLR and LMR levels were compared before and after surgery in patients with breast cancer.Correlations between NLR and LMR with clinicopathological characteristics of patients with breast cancer were analyzed.The patients were grouped according to prognosis results by follow-up,and multivariate Cox proportional hazards model was used to analyze risk factors affecting prognoses of patients with breast cancer.Results After surgery,NLR values were significantly lower,while LMR values were significantly higher than those before surgery in patients with breast cancer(P<0.01).According to the optimal critical values of NLR and LMR before surgery,the patients were divided into high NLR group(equal or more than 2.38,n=31)and low NLR group(less than 2.38,n=57),high LMR group(equal or more than 5.46,n=33)and low LMR group(less than 5.46,n=55).There were no statistically significant differences in clinicopathological characteristics such as age,tumour node metastases(TNM)stage,histological grade,lymph node metastasis,progesterone receptor,estrogen receptor,human epidermal growth factor receptor 2(EGFR-2)and Ki-67 expression between high NLR group and low NLR group,and between high LMR group and low LMR group(P>0.05).TNM stage Ⅲ-Ⅳ,high expression of Ki-67,high value of NLR,low value of LMR,and no postoperative radiotherapy or chemotherapy were independent risk factors affecting prognoses of patients with breast cancer(P<0.05,P<0.01).Conclusion NLR and LMR have no significant correlation with clinicopathological characteristics,but are closely related to prognosis,and NLR and LMR are effective biomarkers in prediction of prognoses of patients with breast cancer.