Predictive value of serum inflammation-related indicators for efficacy of neoadjuvant chemotherapy and postoperative disease-free survival in triple-negative breast cancer patients with axillary lymph node metastasis
10.3760/cma.j.cn115355-20240308-00110
- VernacularTitle:血清炎症相关指标对腋窝淋巴结转移的三阴性乳腺癌患者新辅助化疗效果及术后无病生存的预测价值
- Author:
Wenjie WANG
1
;
Zexin HAN
;
You MENG
;
Ying WANG
;
Jie ZHU
;
Xianmin LI
;
Lian LIAN
Author Information
1. 苏州市立医院（南京医科大学附属苏州医院）放疗科，苏州 215001
- Publication Type:Journal Article
- Keywords:
Triple negative breast neoplasms;
Neutrophil-to-lymphocyte ratio;
Platelet-to-lymphocyte ratio;
Immune inflammatory index;
Chemotherapy, adjuvant;
Patholog
- From:
Cancer Research and Clinic
2024;36(12):887-892
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of serum inflammation-related indicators in predicting the effect of neoadjuvant chemotherapy and postoperative disease-free survival (DFS) of triple-negative breast cancer (TNBC) patients with axillary lymph node metastasis.Methods:A retrospective case series study was conducted. The data of 99 TNBC patients with axillary lymph node metastasis who underwent surgery after EC-T regimen (sequential docetaxel followed by epirubicin and cyclophosphamide) neoadjuvant chemotherapy at Suzhou Municipal Hospital and Xiangcheng People's Hospital from June 2016 to May 2022 were collected. All patients were required to collect peripheral blood samples within one week prior to puncture, and platelet, neutrophil and lymphocyte counts were analyzed using the blood analyzer. C-reactive protein level was analyzed using the fully automated biochemical analyzer, and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and immune inflammatory index (SII) were further calculated. Patients were divided into pathological complete remission (pCR) group and non-pCR group based on postoperative Miller Payne score, and the levels of various serum inflammation-related indicators before neoadjuvant chemotherapy were compared between the two groups; non-pCR patients were divided into high and low groups based on the median level of each indicator. Kaplan-Meier method was used to analyze the postoperative DFS status of each group. The impact of serum inflammatory-related indicators before neoadjuvant chemotherapy on postoperative DFS of patients was analyzed using Cox proportional hazards model for univariate and multivariate analyses.Results:The median age [ M ( Q1, Q3)] of 99 patients was 50 years old (39 years old, 64 years old); 47 cases were human epidermal growth factor receptor (HER2)-, 33 cases were HER2+, and 19 cases were HER2++ and fluorescence in situ hybridization-negative; there were 22 cases of pCR patients and 77 cases of non-pCR patients. Twenty-nine patients experienced recurrence or metastasis after surgery. The platelet count, PLR and SII of pCR group before neoadjuvant chemotherapy were lower than those of non-pCR group, and the differences were statistically significant (all P < 0.05). Among non-pCR patients, the DFS of high lymphocyte count before neoadjuvant chemotherapy group was better than that of low lymphocyte count group, while the DFS of high CRP, NLR, PLR, and SII groups was worse than that of low CRP, NLR, PLR, and SII groups, and the differences were statistically significant (all P < 0.05). Univariate analysis showed that lymphocyte count, NLR, PLR, CRP, and SII before neoadjuvant chemotherapy were all influencing factors for postoperative DFS in TNBC patients with axillary lymph node metastasis after neoadjuvant chemotherapy (all P < 0.05). Multivariate analysis showed that SII was an independent influencing factor for postoperative DFS in TNBC patients with axillary lymph node metastasis after neoadjuvant chemotherapy ( HR = 2.406, 95% CI: 1.147-5.617, P = 0.024). Conclusions:Serum inflammation-related indicators before neoadjuvant chemotherapy can serve as predictive factors for the efficacy of neoadjuvant chemotherapy and postoperative DFS in TNBC patients with axillary lymph node metastasis.
