中性粒细胞与淋巴细胞比值对三阴性乳腺癌临床预后及与Ki - 67表达的影响

目的 探讨中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio，NLR）对三阴性乳腺癌的临床预后影响及与Ki - 67表达的关系。方法 回顾性分析2006年1月 - 2012年12月于我院乳腺外科住院治疗的134例三阴性乳腺癌患者。NLR最佳临床分界值采用ROC曲线确定，并依此分NLR＜2.64组和NLR≥2.64组。临床独立预后因素采用单因素和多因素Cox回归模型分析。术后生存时间和生存曲线比较采用Kaplan - Meier和log - rank方法。Ki - 67的表达采用免疫组织化学方法检测。结果 NLR是三阴性乳腺癌的独立预后因素，最佳临界值为2.64。NLR＜2.64组术后中位DFS为39.10月，中位OS为52.30月；NLR≥2.64组术后中位DFS为27.35月，中位OS为37.35月。2组术后DFS和OS比较，差异具有统计学意义（P＜0.05）。NLR低组伴Ki - 67表达阴性的三阴性患者术后中位DFS和OS生存时间显著高于其他情况。结论 NLR是三阴性乳腺癌的关键影响预后因素，具有重复性强、非侵袭性、方便实用等特性，可用于预测三阴性乳腺癌临床预后。

Effect of neutrophil to lymphocyte ratio (NLR) in patients with triple negative breast cancer and its relationship with Ki-67 expression

The study aimed to explore the potential prognostic significance of neutrophil to lymphocyte ratio(NLR)in patients with triple negative breast cancer(TNBC) and its relationship with Ki-67 expression. Methods 134 patients with TNBC were enrolled in the present study in our hospital from January 2006 to December 2012. The receiver operating characteristic curve(ROC) was used to determine the optimal cutoff value of NLR, and NLR <2.64 group and NLR ≥2.64 group were divided based on the optimal cutoff value. The univariate and multivariate COX proportional hazards regression model were used to evaluate the independent prognostic factors. The survival time was analyzed by the Kaplan-Meier plots and log-rank test. The Ki-67 expression was analyzed by the immunohistochemistry method. Results NLR was the independent prognostic factor of TNBC, and the optimal cutoff value was 2.64. In NLR<2.64 group, the median disease free survival(DFS) was 39.10 months, and the median overall survival(OS) was 52.30 months, respectively. In NLR ≥2.64 group,the median DFS was 27.35 months, and the median overall survival(OS) was 37.35 months, respectively. The median DFS and OS time of patients with low NLR were longer than for those with high NLR by using log-rank methods(P<0.05). Patients with Ki-67 expression negative and NLR <2.64 group would survive longer than other conditions. Conclusion NLR is an independent prognostic factor of TNBC, and has advantages of being reproducible, noninvasive, and convenient. It is a good and effective predictor of prognosis in patients with TNBC.