dNLR、MRR对乳腺癌患者新辅助化疗疗效的评估价值

Evaluation value of dNLR and MRR on efficacy of neoadjuvant chemotherapy in patients with breast cancer

目的研究衍生粒淋比(dNLR)、单核细胞红细胞比率(MRR)对乳腺癌患者新辅助化疗疗效的评估价值。方法回顾性分析2021年12月至2022年10月于该院进行新辅助化疗的乳腺癌患者110例,根据患者新辅助化疗临床疗效分为有效组与无效组,分析dNLR、MRR与乳腺癌患者新辅助化疗疗效的关系,并绘制受试者工作特征(ROC)曲线分析二者对乳腺癌患者新辅助化疗疗效的预测价值,同时采用多因素Logistic回归分析影响乳腺癌患者新辅助化疗疗效的因素。结果110例乳腺癌患者的化疗有效率为78.18%,有效组的dNLR、MRR均明显低于无效组(P<0.05);dNLR、MRR单项及联合预测乳腺癌患者新辅助化疗疗效的曲线下面积(AUC)分别为0.815(95%CI:0.732~0.893)、0.671(95%CI:0.628~0.865)、0.868(95%CI:0.791~0.921),联合预测的AUC大于单项预测(P<0.05)。不同肿瘤最大径、病理类型、TNM分期、淋巴结转移情况、dNLR及MRR患者的化疗疗效比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,肿瘤最大径≥5 cm、病理类型为浸润性癌、TNM分期Ⅲ期、淋巴结转移、dNLR>3.01及MRR>5.98均是乳腺癌患者新辅助化疗无效的影响因素(P<0.05)。结论dNLR、MRR越高乳腺癌患者新辅助化疗疗效越差,二者可作为预测乳腺癌新辅助化疗疗效的有效指标,临床可通过对其监测而调整治疗方案。

Objective To study the evaluation value of derived granulocyte-lymphocyte ratio(dNLR)and monocyte to red blood cell ratio(MRR)in the efficacy of neoadjuvant chemotherapy in the patients with breast cancer.Methods A retrospective analysis was performed on 110 patients with breast cancer patients receivingneoadjuvant chemotherapy in this hospital from December 2021 to October 2022.According to the clinical efficacy of neoadjuvant chemotherapy,the patients were divided into the effective group and ineffective group,and the relationship between dNLR and MRR with the efficacy of neoadjuvant chemotherapy in the patients with breast cancer was analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze their predictive value for chemotherapeutic efficacy,meanwhile the multi-factor Logistic regression was used to analyze the factors affecting the efficacy of neoadjuvant chemotherapy in the patients with breast cancer.Results The effective rate of chemotherapy in 110 patients with breast cancer was 78.18%,and dNLR and MRR in the effective group were significantly lower than those in the ineffective group(P<0.05).The areas under the curve(AUC)of dNLR and MRR single and combined prediction of neoadjuvant chemotherapy efficacy in the patients with breast cancer were 0.815(95%CI:0.732-0.893),0.671(95%CI:0.628-0.865)and 0.868(95%CI:0.791-0.921)respectively,AUC of combined prediction was greater than that of single item prediction(P<0.05).There were statistically significant differences in the chemotherapy efficacy among the patients with different tumor sizes,pathological types,TNM stages,lymph node metastasis,dNLR and MRR(P<0.05).The multivariate Logistic regression analysis showed that the maximum diameter of tumor≥5 cm,invasive cancer pathological type,TNM stage Ⅲ,lymph node metastasis,dNLR>3.01 and MRR>5.98 were all influencing factors of ineffective neoadjuvant chemotherapy for breast cancer(P<0.05).Conclusion The higher the dNLR and MRR,the worse the efficacy of neoadjuvant chemotherapy in the patients with breast cancer.The two can be used as effective indicators to predict the efficacy of neoadjuvant chemotherapy in breast cancer,and the treatment plan can be adjusted through their monitoring in clinic.