4种炎症指标对III期乳腺癌预后的相关性研究

Correlation between 4 Inflammatory Indicators and Prognosis of Patients with Stage III Breast Cancer

摘要: 目的：探讨III期乳腺癌患者治疗前系统性炎症反应指数(SII)、中性粒细胞–淋巴细胞比值(NLR)、血小板–淋巴细胞比值(PLR)和单核细胞–淋巴细胞比值(MLR)与预后的相关性。方法：纳入2013年12月~2018年12月期间在陕西省肿瘤医院确诊为III期乳腺癌86例患者。计算患者SII、NLR、PLR和MLR的最佳截断值，并分为高、低水平组。观察4项指标高、低水平组与临床病理特征的关系。比较高、低水平组生存时间(OS)差异。对影响预后的因素行单因素、多因素分析。结果：III期乳腺癌患者3、5年存活率为72.3%、55.4%。SII、NLR、PLR的高水平组和MLR低水平组的OS较SII、NLR、PLR低水平组和MLR高水平组短。单因素分析结果显示，未接受放疗、高SII、高NLR、高PLR影响III期乳腺癌患者OS的不良因素(P < 0.05)。Cox多因素分析结果显示：是否放疗(HR = 0.432, 95% CI: 0.217~0.861, P = 0.017)、SII评分(HR = 2.865, 95% CI: 1.019~8.054, P = 0.046)是影响III期乳腺癌患者OS的独立预后因素。结论：高SII、高NLR、高PLR的III期乳腺癌患者OS较短，其中SII ≥ 306.99是III期乳腺癌患者OS的独立影响因子。

Abstract: Objective: To explore the correlation between pre-treatment systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lym-phocyte ratio (MLR) and prognosis in the stage of breast cancer patients. Methods: The clinicopath-ologic data of patients diagnosed with stage III breast cancer from December 2013 to December 2018 in Shaanxi Cancer Hospital were retrospectively analyzed. The optimal cut-off values of SII, NLR, PLR and MLR were calculated and divided into high and low level groups. Observe the rela-tionship between the high and low level groups of the four indicators and the clinicopathological features. Compare the survival time (OS) differences between the high and low level groups. The factors affecting the prognosis were analyzed by Univariate analysis and multivariate regression analysis. Results: The 3- and 5-year survival rates of patients with stage III breast cancer were 72.3% and 55.4%. The OS of SII, NLR, PLR high level group and MLR low level group was shorter than that of SII, NLR, PLR low level group and MLR high level group. Univariate analysis results showed that non-radiotherapy, high SII, high NLR, high PLR affect the adverse factors of OS in patients with stage III breast cancer (P < 0.05). The Cox multivariate analysis results showed that whether radiothera-py (HR = 0.432, 95% CI: 0.217~0.861, P =0.017) and SII score (HR = 2.865, 95% CI: 1.019~8.054, P = 0.046) were the independent prognostic factors affecting the OS in the patients with stage III breast cancer. Conclusion: Stage III breast cancer patients with high SII, NLR and PLR have shorter OS, and SII ≥ 306.99 was the independent influencing factor.