| BackgroundBreast cancer(BC)is the most common cancer among female cancers,the degree of malignancy is high,the overall prognosis is poor.Among which the triple negative breast cancer(TNBC)is a highly metastatic and aggressive subtype of breast cancer,accounting for about 15-20% of breast cancer.It is defined as the loss of expression of estrogen receptor,progesterone receptor and human epidermal growth factor receptor-2.Patients with TNBC often show early metastasis,high recurrence rate,and high malignant degree of biological characteristics due to poor differentiation.The classical clinicopathological features that support the prognosis of breast cancer are tumor diameter,tissue type,pathological grade,and lymph node metastasis.In recent years,relevant scholars have found that there is a relationship between inflammation and tumor cells,but currently there are few studies on the correlation of systemic inflammatory markers in TNBC patients.This retrospective study investigated the Platelets to Lymphocyte Ratio(PLR),Neutrophil to Lymphocyte Ratio(NLR),preoperative lymphocyte ratio in patients with TNBC.NLR),Lymphocyte to Monocyte Ratio(LMR),and relationships between clinical characteristics,disease-free survival(DFS)and overall survival(OS)in TNBC patients.PurposeTo explore the relationship between preoperative hematologic biomarkers PLR,NLR and LMR and clinical characteristics of TNBC patients and whether they can play a role in predicting the prognosis of TNBC patients.MethodFrom January 2010 to December 2021,120 cases of TNBC patients were collected from Huaihe Hospital of University and their prognosis was followed up by telephone and outpatient service.A database of TNBC patients was created.The data were analysed using SPSS(IBM SPSS 25.0,SPSS Inc.).Frequency were used for descriptive analysis of clinical data,and all data were expressed as median.They were divided into high NLR and low NLR group,high PLR and low PLR group,and high LMR and low LMR group;and differences between groups were analysed by chi-squared test;the prognosis of TNBC patients was analysed by Log-Rank test for univariate analysis and COX proportional risk model for multifactorial analysis,and survival curves were plotted by Kaplan-Meier method with Log-Rank test,p<0.05 indicated that the differences were statistically significant.Result1.The optimal threshold values of preoperative peripheral blood NLR,PLR and LMR were determined by ROC curve for predicting mortality of patients with triple-negative breast cancer,and the optimal cut-off value of NLR was determined as 4.643 [area under the curve(AUC)=0.729(p= 0.002)].The best truncation value of PLR was determined to be 184.857 [area under curve(AUC)=0.706(p=0.005)] and the best truncation value of LMR was determined to be 7.538[area under curve(AUC)=0.764(p = 0.000)].2.There was no significant difference between the two groups in age,menstrual status,lymph node metastasis,stage,maximum tumor diameter,operation method,local radiotherapy,and vascular cancer thrombus.There were significant differences in histological grade and ki67 index(p<0.05).3.There was no significant difference in age,menstrual status,lymph node metastasis,stage,maximum tumor diameter,operation method,local radiotherapy,and vascular cancer thrombus between the two groups.There were significant differences in histological grade and ki67 index(p<0.05).4.There was no significant difference between the two groups in age,menstrual status,lymph node metastasis,stage,maximum tumor diameter,surgical method,local radiotherapy,histological grade and vascular cancer thrombus.There was statistical significance in ki67 index(p<0.05).5.DFS of triple-negative breast cancer patients in low NLR group,low PLR group and high LMR group were significantly longer than those in high NLR group,high PLR group and low LMR group,respectively;The OS of triple negative breast cancer patients in high NLR group,high PLR group and low LMR group was significantly shortened than that in low NLR group,low PLR group and high LMR group,respectively,and the difference was statistically significant(p<0.05).6.DFS of patients with triple-negative breast cancer were correlated with NLR level(p= 0.003),PLR level(p= 0.004),LMR level(p= 0.000)and lymph node metastasis(p= 0.026).In the lymph node metastasis group(HR=2.780,95%CI=1.084-7.131),p= 0.033),NLR(HR=4.161,95%CI=1.483-11.680,p=0.007),PLR(HR=4.005,95%CI=1.427-11.244,p= 0.008)and LMR(HR=7.477,95%CI=2.164-25.837,p =0.001)was an independent prognostic factor for disease-free survival(DFS)in patients with triple-negative breast cancer.7.OS in patients with triple-negative breast cancer was correlated with NLR level(p =0.001),PLR level(p =0.003)and LMR level(p =0.000),among which NLR(HR=4.680,95%CI=1.666-13.150,p=0.003),PLR(HR=4.204,95%CI=1.498-11.800,p =0.006)and LMR(HR=7.352,95%CI=2.127-25.414,p=0.002)was an independent prognostic factor for overall survival(OS)of triple negative breast cancer patients.Conclusion1.The DFS ratio of triple negative breast cancer patients in the low NLR group,low PLR group and high LMR group was significantly prolonged,respectively,and the OS was also significantly prolonged;2.NLR,PLR and LMR are all influencing factors of DFS and OS in triple-negative breast cancer patients,among which LMR is a protective factor for prognosis,NLR and PLR are risk factors for prognosis,and NLR,LMR and PLR are independent influencing factors of DFS and OS. |
