| Objective:Explore the peripheral inflammatory-related markers(Neutrophil to lymphocyte ratio(NLR),Lymphocyte to monocyte ratio(LMR)and platelet to lymphocyte ratio(PLR))of HER-2 positive breast cancer patients for neoadjuvant targeted therapy(NTT)curative effect predictive value,providing new methods for rapid,simple and minimally invasive screening of treatment-sensitive HER-2 positive breast cancer patients.Methods:Collect clinicopathological data and peripheral blood before treatmentof 92 breast cancer patients who were diagnosed as HER-2 positive by hollow needle puncture pathology and had NTT in the First Affiliated Hospital of Nanhua University,the Second Affiliated Hospital of Nanhua University,and Xiangya Hospital of Central South University From June 2019 to June 2020.According to whether pCR was achieved after NTT,they were divided into pCR group and non-pCR group,and the differences of markers between the two groups were compared through single factor analysis to Construct a ROC curve of meaningful inflammation-related indicators,and then analyze the combined indicators of statistically significant differences in inflammation-related indicators through the method of Logistic multivariate regression analysis,construct a ROC curve of combined indicators,and evaluate the efficacy of NLR,PLR,LMR,and combined indicators for predicting the efficacy of NTT for HER-2 positive breast cancer patients.Finally,a linear correlation analysis was performed on the correlation between the levels of inflammatory-related indicators before treatment that were statistically different.Results:(1)Among 92 patients,32 had pCR and 60 had non-pCR after NTT.The total pCR rate was 34.78%.Compared with the non-pCR group,the clinicopathological data of the pCR group: There was no significant difference in menstrual status,axillary lymph node status,tumor clinical stage,pathological tissue grade,NTT treatment cycle and NTT regimen(P>0.05);age(49.66±5.56 VS 48.70±6.13),BMI(25.97±3.60 VS 24.86±3.55),B-ultrasound tumor longest diameter(36.59±3.71 VS 35.65±4.08)),MRI tumor longest diameter(32.19±4.40 VS 32.58±4.28),the difference was not statistically significant(P>0.05);and there was no significant difference between B-ultrasound tumor grade and MRI tumor grade(P>0.05).(2)In this study,the peripheral blood inflammation-related indicators before treatment Comparison,between the pCR group and the non-pCR group,lymphocytes(2.09±0.58 VS 1.88±0.53),monocytes(0.39±0.12 VS 0.44±0.14)and LMR(5.74±2.27 VS 4.84±2.45)was not statistically significant(P>0.05);neutrophils(3.05±0.99 VS 3.85±1.19),platelets(204.75±53.91 VS231.03±58.61),NLR(1.53±0.52 VS 2.25±1.18)and PLR(103.76±35.09 VS 133.15±56.25)was statistically significant(P<0.05).(3)NLR and PLR which had statistically significant are used to construct ROC curves for predicting whether patients with HER-2 positive breast cancer will reach pCR after NTT,We get the AUC value is 0.7474,the Cut off value is 1.84,and the sensitivity and specificity are 65.0% and 81.2% about NLR;and for PLR the AUC value is 0.6719,the Cut off value is 92.74,the sensitivity and specificity are 85.0% and 46.8%.(4)Due to the poor sensitivity of NLR and poor specificity of PLR about prediction performance,we Calculate logit(F)=1.96-0.00065PLR-1.40600 NLR by using Logistic multivariate regression analysis,and F was used as the probability P value of the combine marker of NLR and PLR,to construct the ROC curve for combine marker predicting whether patients with HER-2 positive breast cancer will reach pCR after NTT,The AUC value is 0.7453,the Cut off value is 0.33,and the sensitivity and specificity are65.0% and 81.2%,respectively.(5)Through the linear correlation analysis between NLR and PLR levels,it is concluded that the NLR level and the PLR level are positively correlated(P<0.05,r=0.8097).Conclusion: Peripheral blood NLR,PLR values and combined marker before treatment have certain predictive value for the efficacy of NTT in patients with HER-2 positive breast cancer.while The peripheral blood LMR value before treatment for the efficacy of NTT in patients with HER-2 positive breast cancer has no predictive value. |
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