| BackgroundWith the development of the global economy and society,the incidence of malignant tumors has increased significantly,which has a major impact on human life safety and physical health.According to statistics by researchers from the American Cancer Society,the top three cancer incidence rates for women in the United States in 2020 are breast cancer,lung cancer,and colorectal cancer,and breast cancer death rate ranks second among all cancers(15% of the total),behind lung cancer.In China,the incidence of breast cancer is also the highest among female malignancies,but the mortality rate is lower than that in the United States,ranking fourth,This shows that the occurrence of breast cancer poses a great threat to women's health.Therefore,it is of great significance to find simple and fast indicators to help clinicians distinguish benign and malignant breast tumors and to predict relevant clinicopathological characteristics.Since Rudolf Virchow proposed in the 19 th century that chronic inflammation may play a key role in cancer,the relevance of inflammation to cancer has attracted much attention,and malignant tumors have been called "wounds that never heal" by many scholars.Chronic inflammation can cause DNA damage and induce mutations in DNA,causing malignant transformation of tissue cells;and the tumor microenvironment composed of differentiated tumor cells,stroma,blood vessels and various inflammatory cells will accelerate the proliferation and metastasis of tumor cells.This cascade between inflammation and tumor promotes the rapid development of tumor cells.In addition,in clinical work,doctors have also found that many inflammatory diseases are closely related to cancer.Red blood cell distribution width(RDW),platelet count(PC),neutrophil to lymphocyteratio(NLR),platelet to lymphocyte ratio(PLR),and systemic immune inflammation index(SII)can reflect the body as indicators of inflammation Inflammatory state and has been corroborated by many studies to correlate with the prognosis of a variety of malignancies.However,the relationship between these indicators and breast cancer,especially the correlation between screening and other clinicopathological characteristics,is less studied.ObjectiveTo explore the value of RDW,SII,NLR and PLR in identifying benign and malignant breast diseases,and analyzed the correlation between the above inflammatory indicators and clinicopathological features,then to explain the clinical significance and role of these indicators in breast cancer.MethodsRetrospective analysis was used to collect 90 female patients who were first diagnosed as breast cancer by histopathology and underwent mastectomy in the First Affiliated Hospital of Henan University from January 2016 to December 2019 as the breast cancer group,and 68 women diagnosed as benign breast proliferative disease by histopathology in the same period as the control group.The differences in inflammation indexes between the two groups were compared,and their diagnostic capabilities were analyzed by receiver operating characteristic curve(ROC).According to the molecular classification,clinical pathological stage,pathological type,presence or absence of vascular invasion and axillary lymph node metastasis,the pathological features further divide the breast cancer components into corresponding subgroups,to explore the correlation between preoperative inflammatory indicators and each subgroup.Results1.RDW,SII,NLR and PLR were significantly higher in the breast cancer group than in the control group(P<0.05).Draw ROC curve: The areas under the curve of RDW,SII,NLRand PLR are 0.758,0.597,0.599,and 0.641,the best cut-off values corresponding to the maximum value of the Youden index are 12.75%,535.01,2.36,and 118.14,the sensitivity is70%,45.6%,31.1%,84.4%,and the specificity is 73.5%,76.5%,88.2%,42.6%.Combined with the comprehensive analysis of the area under the curve,sensitivity and specificity,RDW is the best auxiliary index for identifying benign and malignant breast diseases.2.The results of each subgroup analysis of the breast cancer group showed that the differences of RDW and SII in each subgroup were not statistically significant(P>0.05).In the axillary lymph node metastasis subgroup,positive patients had significantly higher NLR and PLR than negative patients(P<0.05),However,the difference between these two indicators in other subgroups is not statistically significant.After binary logistic regression analysis,it is believed that NLR and PLR cannot be predictors of axillary lymph node status(P>0.05).Conclusion1.Preoperative RDW,SII,NLR and PLR can effectively distinguish breast cancer patients from patients with benign breast hyperplasia.Comprehensive comparison of RDW is better than other indicators and can be used as an auxiliary indicator to assist doctors in identification.2.The preoperative NLR and PLR of patients with axillary lymph node metastasis were significantly higher than those without metastasis.Therefore,the increase of preoperative NLR and PLR has a certain hint for breast cancer axillary lymph node metastasis. |
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