外周血炎性指标在三阴性乳腺癌新辅助化疗中的临床研究
|
摘要
目的探讨治疗前外周血炎性指标在三阴性乳腺癌(triple negative breast cancer,TNBC)新辅助化疗(NAC)中的作用及其与临床病理因素的关系。方法根据ROC曲线,制定外周血炎性指标临界值,对比化疗前不同外周血炎性指标与化疗后病理完全缓解(pCR)率及临床病理因素的关系。结果中性粒细胞计数与TNBC患者的年龄、Ki67、脉管癌栓、肿瘤大小、淋巴结转移状况密切相关;淋巴细胞(ALC)低组较高组的患者肿瘤分级越高,直径越大,淋巴结转移数目越多;高中性粒细胞计数/淋巴细胞计数(NLR)组的患者较低NLR组的患者更年轻,Ki67更高,淋巴结转移个数更多,且具有脉管癌栓的人数更多;高ALC组与低NLR组与对照组相比均表现出较高的pCR率。结论首次证实了TNBC患者NAC后高淋巴细胞计数、低NLR与pCR的统计学相关性,并提示了治疗前外周血炎性细胞计数的预测价值。
Objective To assess the correlation between peripheral inflammation/immune biomarkers preoperative and clinical pathological factors in neoadjuvant chemotherapy(NAC) patients with triple negative breast cancer(TNBC). Methods The critical value of peripheral inflammation/immune biomarkers was established according to ROC curve, and the relationship between clinical pathological facters and pCR rate after NAC was compared. Results Neutrophilic granulocyte count was closely related to the patients age, Ki67, vasculature, tumor size and lymph node metastasis of patients with TNBC. Patients in lower lymphocyte count group with higher tumor grade, larger diameter and more number of lymph node metastases compared with higher lymphocyte count group. The number of lymph node metastases of patients in the high neutrophil-to-lymphocyteratiol(NLR) group was significantly higher than that in the low NLR group, the patients in the high NLR group were younger, the Ki67 was higher, and the number of patients with vascularized cancer was higher.The high lymphocyte group and the low NLR group showed higher pCR rate than the control group. Conclusion It is first confirmed that high lymphocyte count and low NLR are related to pCR rate in TNBC after NAC. The predictive value of peripheral inflammation/immune biomarkers before treatment is suggested.
Objective To assess the correlation between peripheral inflammation/immune biomarkers preoperative and clinical pathological factors in neoadjuvant chemotherapy(NAC) patients with triple negative breast cancer(TNBC). Methods The critical value of peripheral inflammation/immune biomarkers was established according to ROC curve, and the relationship between clinical pathological facters and pCR rate after NAC was compared. Results Neutrophilic granulocyte count was closely related to the patients age, Ki67, vasculature, tumor size and lymph node metastasis of patients with TNBC. Patients in lower lymphocyte count group with higher tumor grade, larger diameter and more number of lymph node metastases compared with higher lymphocyte count group. The number of lymph node metastases of patients in the high neutrophil-to-lymphocyteratiol(NLR) group was significantly higher than that in the low NLR group, the patients in the high NLR group were younger, the Ki67 was higher, and the number of patients with vascularized cancer was higher.The high lymphocyte group and the low NLR group showed higher pCR rate than the control group. Conclusion It is first confirmed that high lymphocyte count and low NLR are related to pCR rate in TNBC after NAC. The predictive value of peripheral inflammation/immune biomarkers before treatment is suggested.
引文
[1] 张乐,赵海东,赵慧,等.多中心、回顾性分析乳腺癌新辅助化疗疗效与分子标记物的变化[J].哈尔滨医科大学学报,2017,51(4):317-320.
[2] Zhao Y,Dong XQ,Li RG,et al.Evaluation of pathologic response and prognosis following neoadjuvant chemotherapy in molecular subtypes of breast cancer[J].Onco Tar Ther,2015,8(6):1511-1521.
[3] Asano Y,Kashiwagi S,Onoda N,et al.Predictive value of neutrophil/lymphocyte ratio for efficacy of preoperative chemotherapy in triple- negative breast cancer[J].Ann Surg Oncol,2016,23(4):1104-1110.
[4] Mitsuya K,Nakasu Y,Kurakane T,et al.Elevated preopera-tive neutrophil-to- lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastasis[J].J Neurosurg,2017,127(2):433-437.
[5] Adams S,Goldstein LJ,Sparano JA,et al.Tumor infiltrating lymphocytes (TILs) improve prognosis in patients with triple negative breast cancer (TNBC)[J].Oncoimmunology,2015,4(9):e985930.
[6] Orditura M,Galizia G,Diana A,et al.Neutrophil to lymphocyte ratio (NLR) for prediction of distant metastasisfree survival (DMFS) in early breast cancer:a propensity score matched analysis[J].ESMO Open,2016,1(2):e000038.
[7] Matsumoto H,Koo SL,Dent R,et al.Role of inflammatory infiltrates in triple negative breast cancer[J].J Clin Pathol,2015,68(7):506-510.
[8] 王绪娟,向敏,陶玉君,等.术前中性粒细胞/淋巴细胞比值在三阴性乳腺癌患者预后评估中的应用[J].癌症进展,2017,15(6):645-649.
[9] Krishnamurti U,Wetherilt CS,Yang J.Tumor-infiltrating lym-phocytes are significantly associated with better overall survival and disease-free survival in triple-negative but not estrogen receptor-positive breast cancers[J].Hum Pathol,2017,64(1):7-12.
[10] 张丽,刘芳芳,付丽.肿瘤间质浸润淋巴细胞在乳腺癌中的意义及评价方法[J].中华病理学杂志,2016,45(4):282-284.
[11] Hong J,Mao Y,Chen X,et al.Elevated preoperative neutrophil-to-lymphocyte ratio predicts poor disease-free survival in Chinese women with breast cancer[J].Tumour Bio,2016,37(3):4135-4142.
[12] Jiang Y,Xu H,Jiang H,et al.Pretreatment neutrophil-lymphocyte count ratio may associate with gastric cancer presence[J].Cancer Biomark,2016,16(4):523-528.
[2] Zhao Y,Dong XQ,Li RG,et al.Evaluation of pathologic response and prognosis following neoadjuvant chemotherapy in molecular subtypes of breast cancer[J].Onco Tar Ther,2015,8(6):1511-1521.
[3] Asano Y,Kashiwagi S,Onoda N,et al.Predictive value of neutrophil/lymphocyte ratio for efficacy of preoperative chemotherapy in triple- negative breast cancer[J].Ann Surg Oncol,2016,23(4):1104-1110.
[4] Mitsuya K,Nakasu Y,Kurakane T,et al.Elevated preopera-tive neutrophil-to- lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastasis[J].J Neurosurg,2017,127(2):433-437.
[5] Adams S,Goldstein LJ,Sparano JA,et al.Tumor infiltrating lymphocytes (TILs) improve prognosis in patients with triple negative breast cancer (TNBC)[J].Oncoimmunology,2015,4(9):e985930.
[6] Orditura M,Galizia G,Diana A,et al.Neutrophil to lymphocyte ratio (NLR) for prediction of distant metastasisfree survival (DMFS) in early breast cancer:a propensity score matched analysis[J].ESMO Open,2016,1(2):e000038.
[7] Matsumoto H,Koo SL,Dent R,et al.Role of inflammatory infiltrates in triple negative breast cancer[J].J Clin Pathol,2015,68(7):506-510.
[8] 王绪娟,向敏,陶玉君,等.术前中性粒细胞/淋巴细胞比值在三阴性乳腺癌患者预后评估中的应用[J].癌症进展,2017,15(6):645-649.
[9] Krishnamurti U,Wetherilt CS,Yang J.Tumor-infiltrating lym-phocytes are significantly associated with better overall survival and disease-free survival in triple-negative but not estrogen receptor-positive breast cancers[J].Hum Pathol,2017,64(1):7-12.
[10] 张丽,刘芳芳,付丽.肿瘤间质浸润淋巴细胞在乳腺癌中的意义及评价方法[J].中华病理学杂志,2016,45(4):282-284.
[11] Hong J,Mao Y,Chen X,et al.Elevated preoperative neutrophil-to-lymphocyte ratio predicts poor disease-free survival in Chinese women with breast cancer[J].Tumour Bio,2016,37(3):4135-4142.
[12] Jiang Y,Xu H,Jiang H,et al.Pretreatment neutrophil-lymphocyte count ratio may associate with gastric cancer presence[J].Cancer Biomark,2016,16(4):523-528.