Effect Of Preoperative NLR-PLR Score On Prognosis Of Breast Cancer Patients And Analysis Of Related Factors

Objective:To investigate the correlation between preoperative neutrophil-lymphcyte ratio（NLR）combined with platelet-lymphocyte ratio（PLR）and clinical pathological parameters and prognosis in patients with breast cancer.Methods:The medical cases of 304 patients who underwent radical breast cancer surgery in the First Affiliated Hospital of China Medical University from January2012 to December 2018 were collected.The preoperative NLR-PLR score was calculated as follows:the patients with NLR（≥2.0）and PLR（≥139）were scored as 2 point,and one item was satisfied as 1 point,and both items were not satisfied as 0 point.The critical values of NLR and PLR and their correlation were determined by receiver operating characteristic（ROC）curve.The data between groups were tested by?^（17）test,survival curve was drawn by Kaplan-Meier method,univariate and multivariate analysis were performed by COX regression model,and ROC curve was drawn based on survival outcome.The prognostic value of NLR-PLR score and inflammatory index of NLR,PLR and lymphocyte monocyte ratio（LMR）were compared.Results:NLR-PLR score was related to the age（P=0.022）,tumor size（P=0.041）,menstruation（P=0.026）,lymph node metastasis（P=0.042）,TNM stage（P=0.028）and radiation therapy（P=0.002）.There were significant differences in survival time among the three groups with NLR-PLR scores of 0,1 and 2,respectively.(?_0,1^（17）=8.540,P=0.003;?_0,2^（17）=22.382,P<0.001;?_1,2^（17）=4.279,P=0.039).Univariate analysis showed that tumor size,estrogen receptor（ER）,progesterone receptor（PR）,lymph node metastasis,TNM stage and NLR-PLR score were related factors affecting the prognosis of patients with breast cancer（P<0.05）.However,in multivariate analysis,the results only suggested that TNM stage,lymph node metastasis and NLR-PLR score were independent factors affecting the prognosis of patients with breast cancer（P<0.05）.In addition,the area under curve（AUC）of ROC curve of the NLR-PLR score was larger than AUC of inflammatory indexes such as NLR,PLR and LMR（P<0.001）.Conclusion:NLR-PLR score is closely linked to the clinical pathological parameters of breast cancer patients and is an independent factor influencing the prognosis.The higher the score,the shorter the survival,and the predictive value is better than PLR,NLR and LMR.