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乳腺癌患者外周血炎症免疫相关指标与临床病理特征及预后的相关性分析

Correlations of peripheral blood inflammatory and immune-related indicators with clinicopathological features and prognosis in breast cancer patients

    摘要
  • 摘要:
    目的 探讨乳腺癌患者外周血炎症免疫相关指标与临床病理特征及预后的相关性。
    方法 将北京市通州区妇幼保健院乳腺外科收治的144例乳腺癌患者纳入肿瘤组, 44例乳腺非典型增生患者纳入癌前病变组, 131例乳腺增生患者纳入乳腺增生组。比较3组中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)。随访3年进行预后评估。根据NLR、PLR、LMR水平不同，将肿瘤组患者分为低NLR组(< 2.12, 67例)、高NLR组(≥2.12, 77例)，低PLR组(< 133.21, 65例)、高PLR组(≥133.21, 79例)，低LMR组(< 5.05, 80例)、高LMR组(≥5.05, 64例)。分析NLR、PLR、LMR与乳腺癌患者临床病理特征及预后的相关性。
    结果 肿瘤组NLR高于癌前病变组及乳腺增生组, PLR高于乳腺增生组, LMR低于乳腺增生组，差异有统计学意义(P < 0.05); 癌前病变组的NLR与PLR高于乳腺增生组, LMR低于乳腺增生组，差异均有统计学意义(P < 0.05)。不同绝经情况、增殖细胞核抗原(Ki-67)患者的PLR水平比较，差异均有统计学意义(P < 0.05)。不同绝经情况患者的LMR水平比较，差异有统计学意义(P < 0.05)。随访3年，肿瘤组患者预后不良5例，预后良好139例。低NLR组与高NLR组、低PLR组与高PLR组、低LMR组与高LMR组的预后不良率比较，差异均有统计学意义(P < 0.05)。Logistic回归分析
    结果 显示, NLR升高、PLR升高是肿瘤患者预后不良的危险因素, LMR升高是保护因素。
    结论 乳腺癌患者外周血炎症免疫相关指标存在异常变化，NLR升高、PLR升高是预后不良的危险因素, LMR升高是保护因素。

     

    Abstract:
    Objective To investigate correlations of peripheral blood inflammatory and immune-related indices with clinicopathological features and prognosis in breast cancer patients.
    Methods A total of 144 breast cancer patients admitted to the Breast Surgery Department of Maternity and Child Healthcare Hospital of Tongzhou District of Beijing were included in cancer group, 44 patients with atypical breast hyperplasia were included in precancerous lesion group, and 131 patients with breast hyperplasia were included in breast hyperplasia group. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were compared among the three groups. A three-year follow-up was conducted for prognosis assessment. Based on different NLR, PLR, and LMR levels, the cancer group was divided into low NLR group (< 2.12, 67 patients), high NLR group (≥2.12, 77 patients), low PLR group (< 133.21, 65 patients), high PLR group (≥133.21, 79 patients), low LMR group (< 5.05, 80 patients), and high LMR group (≥5.05, 64 patients). The correlations of NLR, PLR, and LMR with clinicopathological features and prognosis in breast cancer patients were analyzed.
    Results NLR in the cancer group was higher than that in the precancerous lesion group and breast hyperplasia group, the PLR was higher than that in the breast hyperplasia group, and the LMR was lower than that in the breast hyperplasia group (P < 0.05). NLR and PLR in the precancerous lesion group were higher and LMR was lower than those in the breast hyperplasia group (P < 0.05). PLR between patients with different menopausal statuses and Ki-67 levels showed statistically significant differences (P < 0.05). LMR between patients with different menopausal status also showed a statistically significant difference(P < 0.05). After a three-year follow-up, 5 patients in the cancer group had a poor prognosis and 139 had a good prognosis. Poor prognosis rates between the low NLR and high NLR groups, low PLR and high PLR groups, and low LMR and high LMR groups showed statistically significant differences (P < 0.05). Logistic regression analysis
    Results indicated that increased NLR and PLR were risk factors for poor prognosis in cancer patients, while increased LMR was a protective factor.
    Conclusion Peripheral blood inflammatory and immune-related indicators in breast cancer patients exhibit abnormal changes. Increased NLR and PLR are risk factors for poor prognosis, while increased LMR is a protective factor.

     

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