| ObjectiveFor patients with locally advanced breast cancer,neoadjuvant chemotherapy is mainly to reduce the tumor volume,improve the surgical resection rate and breast conserving surgery rate.Studies have shown that patients with pathologic complete response after neoadjuvant therapy have a better prognosis.However,the current indicators,such as magnetic resonance,genetic testing and other technologies have economic and operational problems.The relationship between inflammation and tumor is also a hot topic.A number of studies have shown that inflammation is closely related to the development of breast tumor,but there is little research on whether inflammation is associated with neoadjuvant efficacy.Studies have shown that platelet-lymphocyte ratio,neutrophil-lymphocyte ratio are related to inflammatory status.Because the peripheral blood is simple and economical to get,so our study aims at analyzing the predictive value of peripheral blood inflammatory indicators.MethodsOur department has designed two prospective clinical trial about oneweek paclitaxel combined with cisplatin for local advanced breast cancer.This retrospective study was conducted in 102 cases of female patients diagnosed with breast cancer from RENJI Hospital in Shanghai Jiaotong University from January 2014 to January 2017 。All patients received paclitaxel combined with cisplatin treatment.Mann Whitney test or t test was used to analyze the differences in the expression of inflammatory indicators,and the logistic regression curve was used to explore the relationship between inflammatory indicators and pathologic complete response.ResultsThe platelet-lymphocyte ratio(PLR)of p CR group was significantly lower than p CR group(p = 0.0289).Logistic univariate analysis showed that NLR(OR = 2.489,95% CI 1.019 ～ 6.081,P = 0.045)was associated with complete response rate in HER2-positive patients.Logistic regression analysis showed that platelet-lymphocyte ratio PLR(OR = 1.011,95% CI1.001 ～ 1.021,P = 0.027),monocyte-lymphocyte ratio MLR(OR=412.983,95% CI 2.342～72812.360,P=0.022),red blood celllymphocyte ratio RLR(OR=2.013,95%CI 1.118～3.625,P=0.020)hemoglobin concentration-lymphocyte ratio HLR(OR = 1.032,95% CI1.008～1.057,P = 0.022),erythrocyte count-lymphocyte ratio RLR(OR=1.032,95%CI 1.008～1.057 lymphocyte count(OR = 0.257,95% CI0.081 ～ 0.808,P = 0.020)were related to pathologic complete response rate.For HER2-positive patients,patients with high NLR were more likely to achieve p CR,and NLR had the highest specificity of p CR(80%),and another inflammation index HLR(sensitivity 73.68%,specificity 64.00%)predicted HER2 Positive p CR patients well according to sensitivity and specificity.ConclusionFor breast cancer patients who received a single-week paclitaxel plus cisplatin,we first observed that PLR was an important factor in predicting p CR rate.Lymphocyte count,monocyte-lymphocyte ratio,hemoglobin concentration-lymphocyte ratio,erythrocyte-lymphocyte ratio might be used to predict pathologic complete response rate.In HER2-positive patients,we first found that high levels of NLR indicated a higher rate of p CR and NLR predicted the highest specificity of p CR.HLR predicted HER2 positive patients with p CR well according to sensitivity and specificity.SignificanceOur study investigated the correlation between the peripheral blood inflammatory indicators and clinicopathological characteristics and pathologic complete response rate of patients with neoadjuvant chemotherapy(NCT).It provides a new economical index for the prediction of pathologic complete response. |
