中性粒细胞/淋巴细胞比值在乳腺癌预后评估中的应用

目的:初步探讨术前中性粒细胞/淋巴细胞比值(NLR)在乳腺癌患者中对预后的影响及预后评估的应用。方法:回顾性分析1997-2007年间武汉大学中南医院甲乳肿瘤科及放化疗科收治的经手术治疗的388例乳腺癌患者的临床资料,根据患者术前外周静脉血NLR分为低NLR组(NLR<4.39,326例)和高NLR组(NLR≥4.39,62例),比较两组患者的5年生存率,分析两组患者临床病理因素与总生存时间之间的关系。结果:低NLR组和高NLR组乳腺癌患者5年生存率分别为74.4%和20.9%(P<0.01)。TNMⅠ、Ⅱ、Ⅲ及Ⅳ期病例中,低NLR组和高NLR组的5年生存率分别为95.7%和50.0%,86.1%和30.8%,65.6%和26.1%,39.3%和8.7%,差异均具有统计学意义(P<0.05)。单因素分析显示NLR≥4.39、淋巴结转移数>3及雌激素受体(ER),孕激素受体(PR)与人表皮生长因子受体2(HER2)三阴是影响乳腺癌总生存时间的危险因素。结论:术前高NLR是影响乳腺癌患者术后复发的单独危险因素,术前NLR大于4.39提示乳腺癌患者预后不良。

Application of Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Breast Cancer

Objective: To explore whether neutrophil-lymphocyte ratio(NLR) is an effective prognostic marker in breast cancer.Methods: Clinical data of 388 patients with breast cancer in Zhongnan Hospital of Wuhan University from 1997 to 2007 were analyzed retrospectively.According to preoperative NLR,the patients were divided into the low NLR group(NLR < 4.39,n = 326) and the high NLR group(NLR≥4. 39,n = 62).The 5-year survival rates of two groups of different TNM stage were separately analyzed,univariate analysis was done to assess for a significant difference between clinicalpathological characteristics and overall survival.Results: The 5-year survival rate in the low NLR group and high NLR group was 74.4% and 20.9% respectively(P < 0.01),and it was also different according to different TNM stages: stage Ⅰ(95.7% vs 50.0%),stage Ⅱ(86.1% vs 30.8%),stageⅢ(65.6% vs 26.1%),stage Ⅳ(39.3% vs 8.7%).There were significant differences of 5-year survival rate in TNM stages between the high and low NLR groups(all P < 0.05).Preoperative NLR≥4.39,tumor size > 5 cm,the number of lymph node metastasis > 3,ER,PR,and Her2 were all negative were risk factors of poor survival of breast cancer.Conclusion: Preoperative NLR≥4.39 was an independent predictor of poorer overall survival,and NLR may be a prognostic marker in patients with breast cancer.