Analysis Of Influencing Factors Of Neoadjuvant Chemotherapy For Breast Cancer

Objective:to assess the relationship between pre-neoadjuvant chemotherapy serum indexes and clinical characteristics and clinical response.Methods:114 breast cancer patients received neoadjuvant chemotherapy from 2017.10to 2019.10 in our center were enrolled in this research.Their Neutrophil count,Lymphocyte count,Neutrophil to Lymphocyte Ratio before neoadjuvant chemotherapy and clinical characteristics including IHC and clinical TNM stage were collected.Independent sample t tests were used to analyze the association between these serum indexes and clinical response and pathological complete response(p CR),otherwise,X~2tests were used to test the association between clinical characteristics and clinical response and p CR,and multiple regression analysis was also used to identify the independent factors for clinical response and p CR with SPSS,p<0.05 was considered statistical significance.Results:(1)21/114 achieved clinical complete response,and 64/114 achieved clinical partial response,29/114 have stable disease,and none of them appear progression,besides,pathological analysis revealed that 24/114 achieved p CR.(2)Single factor analysis showed that pre-neoadjuvant chemotherapy N count,NLR,molecular subtype,ki67 index and histological grade affect clinical response(p<0.05).N count and NLR were 3.15±1.339 and 2.04±1.167 in clinical response group,while N count and NLR were 3.79±1.345 and 2.74±1.302 in nonresponse group,respectively.Pre-neoadjuvant chemotherapy N count,NLR,ki67 index,molecular subtype,N stage and histological grade were associated with p CR(p<0.05).N count and NLR were2.62±1.296 and 1.58±0.872 in p CR group,while N count and NLR were 3.49±1.329and 2.39±1.267 in non-p CR group,respectively.(3)Multiple regression analysis revealed that molecular subtype and histological grade independently positive correlated with clinical response(regression coefficient:1.314and 1.069,OR:3.722 and 2.913,95%CI:1.699-8.153 and 1.408-6.028,respectively).Molecular subtype,N stage and histological grade independently positive correlated with p CR(regression coefficient:0.767,0.957 and 0.725,OR:2.153,2.605 and 2.064,95%CI:1.065-4.353,1.003-6.765 and 1.103-3.862,respectively).(4)For breast cancer patients with luminal molecular subtype,the pre-neoadjuvant chemotherapy histological grade independently positive correlated with clinical response(regression coefficient:1.272,OR:3.569,95%CI:1.523-8.364).For breast cancer patients with non-luminal molecular subtype,NLR and histological grade were related to p CR.NLR was negatively correlated with p CR(regression coefficient:1.038,OR:0.354,and 95%CI:0.142-0.885),and histological grade was positively correlated with p CR(regression coefficient:1.181,OR:3.257,95%CI:1.198-8.858).(5)For premenopausal breast cancer patients,the pre-neoadjuvant chemotherapy molecular subtype and histological grade independently positive correlated with clinical response(regression coefficients:1.781 and 0.965,OR:5.935 and 2.625,95%CI:1.532-22.985 and 1.115-6.177).NLR and histological grade were related to p CR.NLR was negatively correlated with p CR(regression coefficient:-2.511,OR:0.081,95%CI:0.007-0.950),and histological grade was positively correlated with p CR(regression coefficient:2.565,OR:12.997,95%CI:1.952-86.549).For postmenopausal breast cancer patients,histological grade independently positive correlated with clinical response(regression coefficient:1.080,OR:2.944,95%CI:1.038-8.345).Molecular subtype independently positive correlated with p CR(regression coefficient:1.668,OR:5.301,95%CI:1.537-18.279).Conclusions:1.Molecular subtype,N stage and histological grade were valuable for guiding neoadjuvant chemotherapy.Molecular subtype and histological grade were related with clinical response after neoadjuvant chemotherapy,besides,molecular subtype,N stage and histological grade were associated with clinical complete response.2.NLR was an independent influencing factor of p CR after neoadjuvant chemotherapy in breast cancer patients with non-luminal molecular subtype and premenopausal breast cancer patients.