炎性指标联合TILs与乳腺癌新辅助疗效关系

Relationship between Inflammatory Markers Combined with TILs and Neoadjuvant Efficacy in Breast Cancer

摘要: 目的：乳腺癌已经成为女性最常见的恶性肿瘤，新辅助化疗在乳腺癌中占有重要地位，本研究主要探讨炎性指标如中性粒细胞淋巴细胞比例(Neutrophil lymphocyte ratio, NLR)、血小板淋巴细胞比(Platelet lymphocyte ratio, PLR)、淋巴细胞单核细胞比(Lymphocyte monocyte ratio, LMR)，肿瘤浸润淋巴细胞(Tumor infiltrates lymphocytes, TILs)对新辅助化疗疗效产生预测作用。方法：回顾性分析青岛大学附属医院2017年6月~2020年6月就诊的乳腺癌患者，收集相关的病理资料，对TILs及化疗前后的NLR进行分析。结果：140例患者中，有21例达到了病理完全缓解，单因素分析显示：新辅助化疗疗效与年龄(P = 0.033)、淋巴结情况(P < 0.01)、激素受体(P < 0.001)、HER-2 (P = 0.024)、Kit-67 (P = 0.016)、分子分型(P = 0.007)、TILs (P = 0.002)、Pre-NLR (P = 0.001)、Delta-NLR (P ≤ 0.001)、Post-NLR (P ≤ 0.001)存在统计学差异，其余因素无明显相关。多因素分析显示：年龄(P = 0.044, 95%CI: 0.851~0.998)、TILs (P = 0.019, 95%CI: 0.031~0.728)与新辅助化疗疗效相关。结论：化疗前后的NLR及前后的差值新辅助疗效相关，TILs能够对疗效单独起到预测作用。

Abstract: Purpose: Breast cancer has become the most common malignant tumor in women, and neoadjuvant chemotherapy plays an important role in breast cancer. In this study, inflammatory indicators such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR), Lymphocyte monocyte ratio (LMR), Tumor infiltrates lymphocytes (TILs) to predict the efficacy of neoadjuvant chemotherapy. Methods: The patients with breast cancer admitted to the Affiliated Hospital of Qingdao University from June 2017 to June 2020 were retrospectively analyzed, and relevant pathological data were collected to analyze TILs and NLR before and after chemotherapy. Results: Among 140 patients, 21 achieved pathological complete response. Univariate analysis showed: The effect of neoadjuvant chemotherapy was correlated with age (P = 0.033), lymph node status (P < 0.01), hormone receptor (P < 0.001), HER-2 (P = 0.024), Kit-67 (P = 0.016), molecular typing (P = 0.007), TILs (P = 0.002), Pre-NLR (P = 0.001), Delta-NLR (P ≤ 0.001), Post-NLR (P ≤ 0.001) had statistical differences, and other factors were not significantly correlated. Multivariate analysis showed that age (P = 0.044, 95%CI: 0.851~0.998) and TILs (P = 0.019, 95%CI: 0.031~0.728) were correlated with the efficacy of neoadjuvant chemotherapy. Conclusion: The NLR before and after chemotherapy and the difference before and after chemotherapy are related to the neoadjuvant efficacy, and TILs can independently predict the efficacy.