Correlation Analysis Of Preoperative Inflammatory Factor Ratio With Prognosis And Clinicopathological Characteristics In Breast Cancer Patients

Background:At present,the main indicators for assessing the prognosis of breast cancer patients include tumour diameter,clinical stage,lymph node metastasis,molecular typing,and hormonal receptor status.However,the prognostic value of inflammatory factors such as neutrophil/lymphocyte NLR,lymphocyte/monocyte LMR,platelet/lymphocyte PLR and other inflammatory factors for preoperative assessment of breast cancer patients is relatively rare and the conclusions are not completely The findings are not entirely consistent.Data and methods:Absolute lymphocyte count(L),absolute monocyte count(M),absolute neutrophil count(N),absolute platelet count(P),serum albumin levels,and clinicopathological characteristics,including lymph node status,age,and estrogen receptor(ER),progesterone receptor(PR),cell proliferation nuclear antigen(Ki-67),and human epidermal growth factor receptor(HER-2).The lymphatic to monocyte ratio(LMR),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and prognostic nutritional index(PNI)were calculated.The relationship between each report and the prognosis and clinical features of breast cancer patients was analysed by statistical methods.Results:1.Univariate analysis showed that LMR value(χ2=4.312,P=0.038),PNI value(χ2=8.086,P=0.004),Her-2 expression status(χ2=5.847,P=0.016),and lymph node status(χ2=15.578,P<0.001)were correlated with 3-year DFS.2.The optimal cut-off value of LMR for predicting DFS was 5.45,with a sensitivity of 85.7% and specificity of 45.5% at a Jorden index of 0.312;the 3-year disease-free survival rate was 86.2% in the low LMR group and 96.3% in the high LMR group,with statistically significant differences between the two groups(P<0.05).3.Cox multifactorial analysis in LMR and prognosis showed that LMR and lymph node status were independent factors affecting the prognosis of invasive breast cancer.The differences between different LMR groupings and age,ER,PR,Her-2,Ki67,and lymph node status were not statistically significant(P>0.05).4.The optimal cut-off value of PNI for predicting DFS was 51.05,the sensitivity was 71.4% and the specificity was 70.2% at a Jorden index of0.416;the 3-year disease-free survival rate was 96.5% in the high PNI group and 85.0% in the low PNI group,with statistically significant differences between the two groups(P<0.05)5.The results of Cox multifactorial analysis in PNI and prognosis showed that PNI(P=0.019)and lymph node status(P=0.001)were independent factors affecting breast cancer prognosis.There was no statistically significant difference between different PNI groupings and patient age,Ki67,ER,PR,Her-2,and lymph node status(all P>0.05).6.In this study,no significant correlation was found between NLR and patient prognosis(P>0.05),and no significant correlation was found between patient prognosis and PLR(P>0.05).7.In the subgroup analysis,LMR,NLR,and PLR were not prognostic predictive markers in hormone receptor-positive tumors(n=116),and their P values were 0.139,0.435,and 0.534,respectively,and only PNI remained a prognostic predictive marker in HR-positive tumors(95% CI0.065-0.877,P=0.031);in HER-2 negative tumors(n=109)with P-values of 0.130,0.513,0.391,and 0.063,respectively,also did not predict prognosis.Conclusions:1.Preoperative peripheral blood LMR in patients with invasive breast cancer is an independent risk factor for patient prognosis,and LMR values are positively correlated with prognosis and can be used as an indicator to assess prognosis.Preoperative LMR was not associated with clinicopathological features of invasive breast cancer.2.Preoperative peripheral blood PNI in patients with invasive breast cancer is an independent risk factor affecting patients’ prognosis,and PNI values are positively correlated with prognosis and can be used as an index to assess prognosis.Preoperative PNI was not associated with the clinicopathological characteristics of invasive breast cancer.3.LMR combined with PNI is a better predictor of prognosis in patients with invasive breast cancer.4.In the subgroup analysis of hormone receptor-positive and HER-2receptor-negative tumors,PNI was a relevant factor affecting the prognosis of hormone receptor-positive tumors,and the remaining indicators did not find prognostic significance in the subgroup analysis.5.In this study,NLR and PLR were not found to be associated with the prognosis of patients with invasive breast cancer.