Correlation Analysis Between Systemic Inflammatory Markers And Pathological Complete Response In Locally Advanced Breast

Objective:To investigate the effect and predictive value of immune inflammatory markers on pathological complete response(pCR)in locally advanced breast cancer(LABC).Methods:We collected clinical data of 98 female patients who diagnosed with locally advanced breast cancer and received neoadjuvant chemotherapy(NACT)and surgery in the Department of Breast Surgery,Affiliated Hospital of Southwest Medical University from February 2019 to February 2022.The retrospective analysis was performed on the peripheral blood parameters including white blood cell count,platelet count,lymphocyte count,monocyte count,clinicopathological features,age and treatment regimen of patients before and after neoadjuvant chemotherapy.The Youden index of the receiver operating characteristic(ROC)curve was used to determine the cut-off values of NLR,PLR,SII.Quantitative variables are converted to binary variables based on the cut-off value.Independent sample T test and Mann-Whitney U ranksum test were used for quantitative variables.Chi-square test,Fisher’s exact test and Mann-Whitney U Ranksum test were used for categorical variables.The factors affecting pCR were analyzed by difference analysis,and the statistically significant factors were included in logistic regression analysis to establish the prediction model chart,The efficiency of the model was evaluated by ROC curve and area under curve(AUC).Results:A total of 98 patients were included,29 patients got pCR with a pCR rate of 29.59%.Univariate analysis showed that,menopause(χ2=4.183,P=0.041),tumor sizes(χ2=8.088,P=0.004),clinical lymph node staging(χ2=4.768,P=0.029),ER status(χ2=4.665,P=0.031),PR status(χ2=6.092,P=0.014)and HER-2 status(χ2=22.15,P<0.001),molecular classification(Fisher,P<0.001),Chemotherapy regimen(χ2=22.145,P=0.006),intravascular cancer emboli(χ2=14.960,P<0.001),NLR(χ2=7.544,P=0.006)、PLR(χ2=15.572,P<0.001)、SII(χ2=14.682,P<0.001)difference were statistically significant.There was no association between pCR and Age,histological grade,Ki-67 level,ΔNLR,ΔPLR,ΔLMR,ΔSII(P>0.05).Binary logistic regression analysis showed that menopause,ER status,Chemotherapy regimen and SII value were important influencing factors for pCR.The prediction model of pCR was established according to Logistic regression analysis:=Logit(P)=0.697-2.974*(menopausal status)-1.932*(ER status)+3.277*(Chemotherapy regimen)-2.652*(SII).ROC curve showed the AUC value was 0.914(0.840-0.961),P<0.05.Suggesting that the model had a good prediction efficiency.Conclusion:SII is an independent predictor of pCR after neoadjuvant therapy for locally advanced breast cancer and have a good predictive efficiency...