Clinical Significance Of The Preoperative Inflammation-related Indexes In Breast Cancer

Objective:To investigate the association of inflammation-related indexes regarding peripheral blood cells including neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR),systemic inmune-inflammation index(SII)and the advanced breast cancer inflammation index(ABI)with prognosis of breast cancer patients and various clinicopathological factors for the exploration of the more appropriate prognosis-related inflammation index for breast cancer.Methods:A total of 152 patients with breast cancer who were admitted to the First Affiliated Hospital of Soochow University upon first visit from April 2010 to March 2013 were retrospectively analyzed and followed up until March 2018.The following information was collected from these patients,including height,weight,test results of blood routine and biochemical profile within one week prior to operation,relevant clinicopathological factors and postoperative recovery condition.The optimal cut-off values were selected by means of ROC curve(NLR=2.05,LMR=6.195 PLR?127.73,SII=632.32×100/L,ABI=492.2).Chi-square test and Log-rank test were used to analyze the relationship between the high/low index value and clinicopathological factors as well as disease-free survival in each group.The independent prognostic factors associated with disease-free survival were determined by using univariate and multivariate Cox regression analysis.Results:1.The NLR level was associated with the pathological type of tumor.The LMR level was associated with the patient's age,menstrual status,HER-2 and the pathological type of tumor,and the PLR level was associated with the menstrual status(P<0.05).The SII level was significantly associated with the pathological type,and there was a significant correlation between the ABI level and the clinical stage of tumor and the involvement of lymph nodes(P<0.01).2.The 5-year disease-free survival of all the 152 cases was 80.26%.Among them,the 5-year disease-free survival was 70.7%and 91.4%in the high-NLR and fow-NLR groups,and 57.5%and 88.4%in the high-SII and low-SII groups,as well as 93.3%and 61.9%in the high-ABI and low-ABI groups,respectively,and the difference was statistically significant(P<0.01);5-year disease-free survival was 86.9%and 72.1%in the high-LMR and low-LMR groups,and 70.3%and 89.7%in the high-PLR and fow-PLR groups,respectively,and the difference was statistically significant(P<0.05).The disease-free survival curve was plotted using Kaplan-Meier method.Log-rank test showed NLR,LMR,PLR,SII,and ABI level are associated with disease-free survival(NLR,PLR,SII,ABI:P<0.01,LMR:P<0.05).3.The univariate analysis showed that ABI,NLR,LMR,PLR,SII and the clinical stage of tumor correlated with disease-free survival significantly(ABI,SII,NLR:P<0.01;LMR,PLR and the clinical stage of tumor:P<0.05).In the multivariate analysis,ABI(HR:0.19,95%Cl:0.05-0.73,P<0.05)and the clinical stage of tumor(HR:2.96,95%Cl:1.42-6.15,P<0.01)were important independent prognostic factors for disease-free survival in breast cancer patients.Conclusions:In breast cancer patients,high NLR,low LMR,high PLR,high SII and low ABI measured prior to operation were associated with poor prognosis,but ABI was superior to other inflammation-related indexes in terms of prognostic capacity.In this study,we have found that preoperative ABI promises to be a factor to evaluate the prognosis of breast cancer.