乳腺癌患者血液NRR和MRR的变化及其临床意义

Changes of blood NRR and MRRR in breast cancer patients and their clinical significance

目的:探讨乳腺癌患者术前中性粒细胞红细胞比率(NRR)和单核细胞红细胞比率(MRR)的变化及其临床意义。方法:选取2020年8月—2021年8月浙江大学医学院附属妇产科医院收治的乳腺癌患者278例为乳腺癌组,按照性别年龄匹配原则,选取健康体检者278例为正常组。分析两组的NRR、MRR和糖类抗原153(CA153)水平,探讨NRR、MRR与乳腺癌患者一般临床资料、不同临床病理特征、TNM分期、分子亚型的关系及其在乳腺癌中的诊断效能。结果:乳腺癌组NRR、MRR的水平分别为0.71(0.55,0.90)和0.09(0.07,0.11);正常组NRR、MRR的水平分别为0.65(0.52,0.80)和0.08(0.07,0.09)。乳腺癌组NRR、MRR的水平均高于正常组,差异均有统计学意义(P<0.05)。年龄<50岁的乳腺癌患者的MRR水平高于年龄≥50岁患者,差异有统计学意义(P<0.05);未绝经患者的NRR、MRR水平均高于已绝经患者,差异有统计学意义(P<0.05);在肿瘤大小方面,肿瘤直径>2cm患者的NRR水平高于肿瘤直径≤2cm患者,差异有统计学意义(P<0.05)。然而NRR、MRR在231例浸润性乳腺癌患者的病理类型、淋巴结转移、TNM分期、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体(HER2)、Ki-67和分子亚型上,差异均无统计学意义(P>0.05)。ROC曲线分析表明,NRR、MRR呈现了较好的乳腺癌诊断性能,NRR和MRR的AUC分别达到了0.575和0.660,见图2。根据约登指数将NRR的cut-off值设为0.874时,其灵敏度为30.22%,将MRR的cut-off值设为0.086时,其灵敏度达到62.95%%。而乳腺癌患者中CA153超过临界值数量仅为12例,灵敏度仅为4.32%。结论:乳腺癌患者NRR、MRR水平显著高于正常组(P<0.05)。NRR与乳腺癌患者是否绝经以及肿瘤大小相关,MRR与乳腺癌患者是否绝经及年龄相关,NRR、MRR在乳腺癌中具有一定的诊断效能,其灵敏度均高于CA153,有助于乳腺癌患者的检出。

Objective To investigate the changes and clinical significance of preoperative neutrophil-to-erythrocyte ratio(NRR)and monocyte-to-erythrocyte ratio(MRR)in breast cancer patients.Methods From August 2020 to August 2021,278 breast cancer patients admitted to Women′s Hospital,School of Medicine,Zhejiang University School of Medicine were selected as the breast cancer group.According to the principle of gender and age matching,278 healthy subjects were selected as the normal group.The levels of NRR,MRR and carbohydrate antigen 153(CA153)were analyzed,and the relationship between NRR,MRR and general clinical data,different clinicopathological features,TNM staging and molecular subtypes of breast cancer patients and their relationship in breast cancer were investigated.Results The levels of NRR and MRR in the breast cancer group were 0.71(0.55,0.90)and 0.09(0.07,0.11),respectively;The levels of NRR and MRR in the normal group were 0.65(0.52,0.80)and 0.08(0.07,0.09),respectively.The levels of NRR and MRR in the breast cancer group were higher than those in the normal group,and the differences were statistically significant(P<0.05).The MRR level of breast cancer patients aged<50 years was higher than that of patients aged≥50 years,and the difference was statistically significant(P<0.05).In terms of tumor size,the NRR level of patients with tumor diameter>2 cm was higher than that of patients with tumor diameter≤2 cm,and the difference was statistically significant(P<0.05).However,the pathological type,lymph node metastasis,TNM stage,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor(HER2),Ki-67 and molecular subtypes,the difference was not statistically significant(P>0.05).ROC curve analysis showed that NRR and MRR showed good breast cancer diagnostic performance,and the AUCs of NRR and MRR reached 0.575 and 0.660,respectively,as shown in Figure 2.According to the Youden index,when the cut-off value of NRR was set to 0.874,the sensitivity was 30.22%,and when the cut-off value of MRR was set to 0.086,the sensitivity reached 62.95%.In breast cancer patients,the number of CA153 exceeding the critical value was only 12,and the sensitivity was only 4.32%.Conclusion The levels of NRR and MRR in breast cancer patients were significantly higher(P<0.05)than those in the normal group.NRR is related to menopause and tumor size of breast cancer patients.MRR is related to menopause and age of breast cancer patients.NRR and MRR have certain diagnostic performance in breast cancer,and their sensitivity is higher than CA153,which is helpful for breast cancer patients.checkout.