Clinical Significance Of RDW-CV、NMR And SII In The Occurrence And Development Of Breast Cancer

Objective: To search for screening indicators of breast cancer by statistical analysis of the differences of inflammatory indicators(RDW-CV,NMR,SII)in patients diagnosed with breast cancer and healthy subjects examined at the same time,and to further explore the correlation between these inflammatory indicators and disease development in patients diagnosed with breast cancer,and to analyze their value in clinical application.Methods: A total of 112 cases of breast cancer patients treated in the Affiliated Hospital of Yan’an University from December 2015 to January 2021 were collected as the case group strictly according to the standard of intake and discharge,a total of 160 healthy people without any abnormality in the routine physical examination of our hospital during the same period were collected as the control group.The blood routine results of the subjects were collected.The recording indexes included the coefficient of variation of red blood cell distribution width(RDW-CV),absolute value of neutrophils(NEU#),absolute value of monocytes(MONO#),platelets(PLT),absolute value of lymphocytes(LYM#),and pathological data of patients in the case group.Excel software was used to collect data,calculate the neutrophils/monocytes ratio(NMR)and systemic immune inflammation index(SII)(neutrophils×platelets/lymphocytes),and further compile and collate the data.SPSS 25.0 software was used for data analysis.Results:(1)A total of 272 subjects were included in this study,including 112 in the case group and 160 in the control group.There were no statistical significance between the two groups in age,height,weight,BMI and menstruation(all P values were greater than0.05).(2)There were statistically significant differences in RDW-CV and SII between the case group and the control group(P<0.01).There was no significant difference in NMR between the two groups(P>0.05).(3)According to logistic regression results,RDW-CV and SII were independent risk factors for the diagnosis of breast cancer(P<0.05).(4)According to the results of ROC curve,the AUC of RDW-CV and SII were all greater than 0.5,and the P values were all less than 0.05.The sensitivity of RDW-CV and SII were 62% and54%,and the specificity were 71% and 76% respectively.While the AUC of NMR was only 0.469,which exceeded the normal value range of this parameter,P>0.05.Combined with RDW-CV and SII,further ROC curve analysis showed that the AUC of RDW-CV and SII combined detection was 0.731,P<0.05,sensitivity was 68%,specificity was 71%.(5)According to the median of RDW-CV and SII in the case group,the case group was divided into high value group and low value group.There were no significant differences in age,height,weight,BMI,menstrual status,tumor clinical stage,pathological type,hormone receptor status,HER-2 status,Ki-67 numerical region and molecular typing among the RDW-CV groups(all P values were greater than 0.05).There were statistically significant differences in tumor clinical stage,pathological type,HER-2 status and molecular typing among SII groups(all P<0.05),while there were no statistically significant differences in age,height,weight,BMI,menstrual status,hormone receptor status and Ki-67 numerical region among SII groups(all P>0.05).(6)There were no significant difference in the RDW-CV and SII of breast cancer patients in case group under different menstrual conditions,ER status,PR status and Ki-67 level(all P values were greater than0.05).There were no statistically significant differences between groups(all P>0.05)in comparison of RDW-CV with different clinical stages,pathological types,HER-2 status and molecular types,while in comparison of SII,there were statistically significant differences between the above groups(all P<0.05).Further pair statistical analysis between groups showed that there was a statistically significant difference between the groups ofⅡ and Ⅲ stage(P=0.007<0.01)in the clinical stage,and there was a statistically significant difference between the groups of non-invasive cancer and invasive non-special cancer in pathological type(P=0.015<0.05),and there were statistically significant differences between the HER-2 positive group and Luminal group(P=0.047<0.05)and the HER-2 positive group and Triple negative group(P=0.034<0.05)in molecular typing.Conclusion: In this study,RDW-CV is an independent risk factor for breast cancer and can be used as an independent screening index for breast cancer,but it has no special significance in the development evaluation of breast cancer;SII in this study are independent risk factors for breast cancer illness,which can be independent as the disease of breast cancer screening index and has great significance in the development evaluation of breast cancer.The higher the SII value,the more likely the patient is to develop disease progression.In the treatment of patients with breast cancer which can be taken as reference to conventional indexes in the process of evaluation;The combination of RDW-CV and SII as the screening index of breast cancer has higher diagnostic accuracy and sensitivity,and has great clinical significance for the early warning of breast cancer;NMR has no clinical significance in this study.