摘要:
目的：本研究旨在探讨NLR与乳腺癌各分子分型预后的关系。方法：回顾性研究秦皇岛市第一医院2009年1月至2011年1月经过病理学确诊的初治乳腺癌患者263例，通过ROC曲线，兼顾敏感性及特异性确定NLR截点(NLR = 2.08)，分为高NLR组(NLR > 2.08)和低NLR组(NLR < 2.08)。所有数据采用SPSS19.0进行统计学分析，通过计算5年生存率，讨论NLR和乳腺癌各分子分型预后的关系。结果：1) 对年龄、肿瘤史、月经状态等因素进行比较，差异无统计学意义。在治疗前白细胞计数方面比较，差异有统计学意义(P < 0.05)。2) 本研究中263例乳腺癌患者5年生存率80.23%，其中NLR > 2.08组65.00%，NLR < 2.08组89.57%，差异具有统计学意义(P < 0.01)。3) Luminal B型、Her-2过表达型中高NLR和低NLR组差异无统计学意义；Luminal A型、三阴型中高NLR和低NLR组差异均有统计学意义(P < 0.05)。4) NLR值和分子亚型是影响乳腺癌患者预后的独立危险因素(P < 0.05)。结论：NLR > 2.08乳腺癌患者较NLR < 2.08患者预后差。NLR值、临床分期和分子亚型是影响乳腺癌患者预后的独立危险因素。
Abstract:
Objective: We performed this study of breast cancer patients to evaluate the prognostic value of the NLR. Methods: We retrospectively analyzed 263 cases of breast cancer patients treated in The First Hospital of Qinhuangdao after pathology diagnosis from January 2009 to January 2011. According to the ROC curve, while taking into account the sensitivity and specificity, we selected NLR = 2.08 as the cut-off value, and divided the patients into low NLR group (NLR < 2.08) and high NLR group (NLR > 2.08). Statistical analysis was performed with the statistical package for the social sciences (SPSS) software package version 19.0. We explore the relationship between NLR and clinical factors on prognosis by calculating 5-year survival rate. Results: 1) In term of age, history of cancer and menopausal status, there was no statistically significant difference. NLR difference between lower and upper groups has statistics significance (P < 0.05) on leukocyte counts before treatment. 2) In this study, 5-year survival rate of 263 cases of breast cancer was 80.23%. In NLR > 2.08 group, it was 65.00%; in NLR < 2.08 group, it was 89.57%. The difference was statistically significant (P < 0.01). 3) The high and low NLR groups have no statistics significance in Luminal B subtype and Her-2 subtype, while it has statistics significance (P < 0.05) in Luminal A subtype and triple-negative subtype. 4) NLR and molecular subtype were identified as independent prognostic factors for survival (P < 0.05). Conclusion: Prognosis in patients with NLR > 2.08 is worse than that in patients with NLR < 2.08. NLR, clinical stages and the molecular subtype are independent factors which influence the prognosis of breast cancer patients.