Predict The Survival Rate Of Triple-Negative Breast Cancer Patients Based On The Nomogram Of RLR,PAB And TNM Stage

Objective: Analyze the relationship between preoperative Red Cell Distribution Width to Lymphocyte Ratio(RLR)and prealbumin(PAB)detection values and the clinicopathological characteristics of triple-negative breast cancer(TNBC)patients.Predict the Survival Rate of Triple-Negative Breast Cancer Patients Based on the Nomogram of RLR,PAB and TNM Stage.Methods: The preoperative RLR and PAB values of 217 triple-negative breast cancer patients were retrospectively analyzed.According to the high and low RLR and PAB values of patients,they are divided into: high RLR group(RLR≥20.2),low RLR group(RLR<20.2);high PAB group(PAB≥272.0),low PAB group(PAB<272.0)(using X-TILE calculated the cut off value RLR=20.2,PAB=272).The correlation between RLR and PAB and clinicopathological factors of patients were compared and analyzed.Univariate and multivariate Cox were used to analyze the impact of RLR,PAB and clinicopathological factors on the survival of TNBC patients.The independent risk factors that affect the disease-free survival(DFS)and overall survival(OS)of patients are constructed to construct a nomogram model and test the effectiveness of RLR combined with PAB in predicting patient survival.Results: 1.The median follow-up time was 64(9-132)months.There were32 patients develop recurrence and metastasis,and 29 patients of death.The 1,3,and 5-year survival rates of the whole group of patients were 98.6%,93.1%,and88.0%,respectively.2.RLR of TNBC patients is related to tumor type,lymphocytes,RDW,WBC,NLR,PLR,MLR.RLR was positively correlated with inflammatory markers such as RDW(r=0.015,P=0.026)PLR(r=0.813,P<0.001)NLR(r=0.841,P<0.001)MLR(r=0.202,P=0.003).PAB value is related to tumor size,EGFR and MLR.3.Univariate analysis: tumor location,tumor size,TNM stage,CK5/6,lymphocytes,RDW,NLR,RLR,PAB are factors that affect DFS in TNBC patients(P<0.05);Age,tumor location,tumor size,Vascular tumor thrombus,TNM stage,lymphocytes,RDW,NLR,RLR,PAB are factors that affect the OS of TNBC patients(P<0.05).4.COX multivariate analysis: TNM stage(P=0.022)(Ⅱ/Ⅰ: HR=1.466,P=0.374 Ⅲ/Ⅰ: HR=4.953,P=0.008),RLR(HR=3.004,P=0.007),PAB(HR=2.843,P=0.022)are independent risk factors for DFS.Age(HR=5.074;P=0.001),tumor size(HR=3.543,P=0.010),TNM stage(P=0.018),RLR(HR=5.768,P<0.001),PAB(HR=3.185,P= 0.037)are independent risk factor for OS in patients.5.The nomogram model construct based on RLR,PAB and TNM stage is significantly better than TNM stage in predicting the survival rate of patients.The constructed nomogram model predicts that the survival rate of TNBC patients is consistent with the actual survival rate calibration curve of patients.Conclusion: Preoperative RLR≥20.2 and PAB<272.0 are independent risk factors affecting the survival of triple-negative breast cancer patients.The construction of a nomogram model based on preoperative RLR,PAB and TNM staging has a certain predictive value for the survival rate of triple-negative breast cancer patients,and the prediction accuracy of the nomogram model is higher than that of TNM staging.