术前检查指标dNLR、SII、CRP/ALB对乳腺癌复发转移的预测价值

doi:10.3969/j.issn.1004-616x.2022.04.007

摘要/Abstract

摘要： 目的：研究术前常规实验室检查指标衍生中性粒细胞与淋巴细胞比值(dNLR)、系统性免疫性炎症指数(SII)、C反应蛋白(CRP)/白蛋白(ALB)比值对乳腺癌患者复发转移的预测价值。方法：选择2016年4月—2019年4月在四川省内江市第二人民医院接受手术治疗的乳腺癌患者作为研究对象，收集临床病理资料，随访复发转移情况并计算无病生存时间，绘制无病生存Kaplan-Meier曲线并通过log-rank检验分析不同临床病理指标与无病生存期的关系，采用COX回归模型分析无病生存的影响因素，采用ROC曲线分析不同指标对无病生存期的预测价值。结果：经无病生存Kaplan-Meier曲线的log-rank检验，不同分期、淋巴结转移、中性粒细胞与淋巴细胞比值(NLR)、血小板和淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、dNLR、SII、CRP/ALB比值的乳腺癌患者累积无病生存率的比较差异有统计学意义(log-rank χ²分别为12.020、5.332、3.923、4.948、15.340、22.970、5.496；均为P<0.05)；经COX回归模型分析，AJCC分期、dNLR、SII、CRP/ALB比值是乳腺癌患者无病生存期的影响因素(P<0.05)；经ROC曲线分析，dNLR、SII、CRP/ALB比值单独指标对乳腺癌患者无病生存期具有预测价值(P<0.05)；在logistic模型中得到dNLR、SII、CRP/ALB比值的回归方程，将其作为联合指标对乳腺癌患者无病生存期具有预测价值且预测效能优于单独指标(P<0.05)。结论：实验室指标dNLR、SII、CRP/ALB比值与乳腺癌术后复发转移有关，3项指标联合能够为预后的评估提供依据。

关键词: 乳腺癌, 复发, 转移, 预后, 预测

Abstract: OBJECTIVE: To study predictive values of preoperative laboratory indexes[derived neutrophil to lymphocyte ratio (dNLR),systemic immune inflammatory index (SII),and C-reactive protein (CRP)/albumin (ALB)] on recurrences and metastases in breast cancer patients. METHODS: The patients who received surgical treatment and diagnosed with breast cancer by postoperative pathology in Sichuan Neijiang Second People's Hospital from April 2016 to April 2019 were selected as the research objects. Their clinical and pathological data, followed-up recurrences and metastases and disease-free survival times was collected. The Kaplan Meier curve of disease-free survival was drawn. Relationships between different clinicopathological data and disease-free survival were analyzed by log-rank test. Influencing factors of disease-free survival were analyzed by COX regression model. Predictive values of different indices on disease-free survival were analyzed using ROC curve. RESULTS: Log rank test of Kaplan-Meier curve of disease-free survival showed that the cumulative disease-free survival rates of breast patients with different tumor stage, lymph node metastasis, neutrophils to lymphocyte ratio,platelet to lymphocyte ratio,lymphocyte to monocyte ratio,dNLR,SII,and CRP/ALB were statistically different (log-rank χ²=12.020,5.332,3.923,4.948,15.340,22.970,5.496,all P< 0.05). COX regression model analyses showed that AJCC stage,dNLR,SII,CRP/ALB were the influencing factors of disease-free survival of breast cancer patients (P<0.05). ROC curve analyses showed that dNLR,SII and CRP/ALB alone had predictive values for disease free survival. Regression equations of dNLR,SII and CRP/ALB were obtained in the logistic model, which could be used as a combined index to predict disease-free survival of breast cancer patients. CONCLUSION: Laboratory indices dNLR,SII and CRP/ALB were related to postoperative recurrences and metastases of breast cancers. The combination of the three indices can provide a basis for prognosis evaluations.

Key words: breast cancer, recurrence, metastasis, prognosis, forecast

中图分类号:

R737.9

王绪娟, 罗永鑫, 李陈强, 王汝晋, 郑婷婷. 术前检查指标dNLR、SII、CRP/ALB对乳腺癌复发转移的预测价值[J]. 癌变·畸变·突变, 2022, 34(4): 284-288,323.

WANG Xujuan, LUO Yongxin, LI Chenqiang, WANG Rujin, ZHENG Tingting. Predictive values of preoperative laboratory indices dNLR, SII and CRP/ALB on recurrences and metastases in breast cancer patient[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2022, 34(4): 284-288,323.

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