| Objective:To investigate Systemic immune-inflammation index(SII)and Eosinophil to lymphocyte ratio(ELR)and eosinophil(E)in preoperative peripheral blood of breast cancer patients and to investigate their correlation with various clinicopathological factors and patient prognosis.Methods:The clinicopathological data of 250 patients with female breast cancer who underwent surgery in Affiliated Hospital of Qingdao University from January 2013 to January2014 were retrospectively analyzed.The receiver operating characteristic(ROC)curve was used to determine the optimal cutoff values for SII,ELR,and E.Breast cancer patients were divided into high SII and low SII groups,high ELR and low ELR groups,high E groups,and low E groups.Chi-square test to compare the relationship between clinicopathological characteristics of each group.Disease free survival(DFS)?Overall survival(OS)were assessed using Kaplan-Meier method.Log-rank test was used to compare the disease-free survival rate of each group.Univariate and multifactor Cox proportional hazard models were used to analyze the prognostic factors of breast cancer patients.Result :1.A retrospective analysis was performed on 250 female breast cancer patients,including 2 patients aged < 35 years and 248 patients aged ?35 years.There were 73 patients with ER receptor negative and 177 patients with ER receptor positive.There were 194 her-2 receptor negative patients and 56 her-2 receptor positive patients.Ki-67 positive rate ?20% : 77 persons,ki-67 positive rate: > 20% : 173 persons.There were 163 patients with tumor ?2cm and 87 patients with tumor of > 2cm.There were 148 patients without axillary lymph node metastasis,64 patients with 1-3 lymph node metastasis,and 38 patients with ?4 lymph node metastasis.There were 47 Luminal A,143 Luminal B and 39 Basal-like 21 ERBB2+.Clinical stage for ? 99,? period,107 ? 44 people;Therewere 169 patients without lymphovascular invasion and 81 patients with lymphovascular invasion.2.The optimal cut-off values of SII,ELR and E were 384.58,0.05 and 0.07 respectively,Breast cancer patients were divided into high SII(SII?384.58)and low SII groups(SII<384.58),high ELR(ELR?0.05)and low ELR(ELR<0.05)groups,high E groups(ELR?0.07),and low E groups(E<0.07).Chi-square test showed that the level of SII group was correlated with ki-67 positive rate(=5.27,P=0.02)and clinical stage(=14.05,P=0.00),the proportion of Ki-67 positive rate in the high SII group is higher than that of the low SII group,and the pathological stage of the high SII group is later than that of the low SII group;The level of ELR group was correlated with the lymphovascular invasion(=4.59,P=0.03).The proportion of lymphovascular invasion in the high-ELR group was higher than that in the low-ELR group.The level of group E was related to the expression of HER-2(= 5.08,P = 0.02),and the negative ratio of her-2 receptor in high-E group was higher than that in low-E group.3.The 5-year disease-free survival rate of all the 250 patients was 84.80%.The 5-year disease-free survival rates of the high SII group and the low SII group were 72.70% and 92.70%,and the difference was statistically significant(Log Rank(MantelCox)=21.69,P<0.05).the 5-year disease-free survival rates of the high ELR group and the low ELR group were 81.20% and 88.90%,and the difference was not statistically significant(Log Rank(Mantel-Cox)=3.14,P>0.05).The 5-year disease-free survival rates of the high E group and the low E group were 83.90% and 87.70%,and the difference was not statistically significant(Log Rank(Mantel-Cox)=0.59,P>0.05);The 5-year overall survival rate of 250 patients was 98.40%.The 5-year disease-free survival rates of the high SII group and the low SII group were 97.00% and 99.30%.and the difference was not statistically significant(Log Rank(Mantel-Cox)=2.87,P>0.05),the 5-year disease-free survival rates of the high and low ELR groups were 97.70% and 99.10%.The difference was not statistically significant(Log Rank(MantelCox)= 0.91,P> 0.05).The 5-year overall survival rates of the high E group and the low E group were 97.9% and 100%.The difference was not statistically significant(Log Rank(Mantel-Cox)= 1.23,P> 0.05).4.For univariate analyses,the results revealed that Ki-67 positive rate(P <0.05),tumor size(P <0.01),pathological TNM stage(P <0.01),number of lymph nodemetastases(P <0.01),and lymphovascular invasion(P <0.05)and SII(P <0.01)were predictors of 5-year disease-free survival rate.Incorporating the above factors into the multivariate COX proportional risk model showed that SII and tumor size were significantly associated with disease-free survival in patients with breast cancer.The risk of recurrence in the high SII group was 4.7 times that of the low SII group(P <0.01,HR = 4.70,95% CI: 2.22-9.93);The risk of recurrence of breast cancer patients with a mass ?2 cm is 0.19 times that of a mass <2 cm(P <0.01,HR = 0.19,95% CI: 0.08-0.49).Conclusion:1.The level of SII is closely related to the Ki-67 positive rate and pathological stage;the level of ELR is closely related to lymphovascular invasion;the level of E is closely related to the expression of Her-2 receptor.2.SII is significantly related to the disease-free survival rate of breast cancer.It is an independent factor for predicting the disease-free survival rate of breast cancer.SII can assess the prognosis of breast cancer patients.but ELR and E can not be used as a prognostic indicator.SII is significantly related to the disease-free survival rate of breast cancer. |
PDF Full Text Request