摘要
目的探讨术前中性粒细胞和淋巴细胞比值(NLR)对乳腺癌患者总体生存期的价值。方法回顾性分析2010~2012年于东莞市人民医院乳腺科诊断为浸润性乳腺癌的280例患者的临床资料,包括手术前的NLR,临床病理资料和预后资料。根据患者术前外周静脉血NLR分为2组:172例低NLR患者(NLR≤2.63)和108例高NLR患者(NLR>2.63)。通过卡方检验和Wilcoxon秩和检验分析两组之间不同临床病理资料的差异。通过Kaplan Meier生存分析及Cox比例风险回归分析NLR对存活的影响。结果高NLR组与年龄(P=0.041)、肿瘤大小(P=0.006)、阳性淋巴结转移(P=0.027)、肿瘤临床分期晚期程度(P=0.008)及表皮生长因子受体-2(P=0.003)有相关性。相比低NLR组患者,高NLR组患者的无病生存期及总体生存期明显下降(P<0.001)。此外,Cox多元回归分析显示术前高NLR是不良无病生存期和总体生存期的独立危险因子,风险率分别为1.600(95%CI:1.370~1.868,P<0.001)和1.497(95%CI:1.262~1.777,P<0.001)。结论术前高NLR是女性乳腺癌患者生存预后的一个独立因素,女性乳腺癌患者其术前NLR与无病生存期和总体生存期有一定的相关性。
Objective To assess the predictive value of Neutrophil-Lymphocyte Ratio （NLR） for overall survival of patient with breast cancer. Methods Clinical data of 280 consecutive patients with invasive breast cancer diagnosed at the Dongguan People＇s Hospital between 2010 and 2012 were reviewed. Preoperational NLR, clinicopathological information and prog-nostic data were collected . According to preoperative NLR levels, patients were divided into 2 groups： the low NLR group （NLR≤2.63, n=172） and the high NLR group （NLR〉2.63,n=108）. Clinicopathological differences between the 2 groups were analyzed by chi-squared test and Wilcoxon rank-sum test. Effect of NLR on survival was examined by Kaplan–Meier survival analysis and Cox proportional hazard regression analyses. Results High NLR was significantly associated with age （P=0.041）, larger tumor size （P=0.006）, positive lymph node metastases （P=0.027）, advanced stages （P=0.008） and HER-2 （P=0.003）. Patients with high NLR had a significant lower disease-free survival （DFS, P〈0.001） and lower overall survival （OS,P〈0.001） than patients with low NLR. The Cox regression multivariate analysis revealed that high pretreatment NLR was independently correlated with poor DFS and OS, with hazard ratio 1.600 （95%CI： 1.370-1.868,P〈0.001） and 1.497（95% CI： 1.262-1.777,P〈0.001）, respectively. Conclusion Elevated pretreatment NLR is an independent factor of poor survival in patients with breast cancer. The pretreatment NLR may be associated with DFS and OS in patients with breast cancer.
出处
《分子影像学杂志》
2018年第1期53-57,共5页
Journal of Molecular Imaging
