Correlation Analysis Of Systemic Inflammatory Markers With Patients With Neoadjuvant Breast Cancer

Objective:To study the correlation between systemic inflammatory indexes and neoadjuvant breast cancer patients,so as to provide convenient and accurate detection methods for neoadjuvant breast cancer patients.Methods:This article retrospectively analyzed 106 patients with neoadjuvant chemotherapy for breast cancer admitted to the Department of Thyroid and Breast Surgery,The First Affiliated Hospital of Wannan Medical College,from 2010 to 2020.It includes the patient’s general clinical data,tumor size,hormonal status,molecular typing,and peripheral blood indicators at admission before neoadjuvant chemotherapy.A chi-square test,a T-test,and a nonparametric test(Mann-Whitney U test)were used for univariate analysis.Finally,for the variables with significance less than 0.05 in univariate analysis,a logistic regression model is established,and a stepwise regression method based on AIC criteria is used to construct a nomogram,ROC and calibration curves of subjects on the basis of the results of multivariate analysis.Results:A total of 106 patients with neoadjuvant therapy for breast cancer were included in this study,and 49 of them had a pathological grade of Miller-Payne grade 4-5 after neoadjuvant therapy.The normality test was carried out for the distribution of continuous variables,and it was found that the distribution of age,height,BMI,platelet-tolymphocyte ratio PLR,lymphocytes to monocytes ratio LMR,neutrophils *platelets/lymphocyte N*P/L was normal,and we used the T-test to test the differences between the two groups;The distribution of body weight,tumor size(varies before,after neoadjuvant therapy,and during neoadjuvant therapy),neutrophils,lymphocytes,neutrophils,monocytes,platelets,neutrophils to lymphocyte ratio NLR,neutrophils*monocytes to lymphocyte ratio N*M/L,and Ki-67 were distributed non-normal,and we tested the differences between the two groups using nonparametric tests.The chi-square test for univariate classification showed that tumor T stage(P=0.047),estrogen receptor ER(P=0.000),progesterone receptor PR(P=0.002),HER-2(P=0.018)and molecular typing(P=0.000)were statistically significant(P <0.05)。In the significance test of univariate continuous variables,age(P=0.000),monocytes N(P=0.000),platelet P(P=0.001),platelet-tolymphocyte ratio PLR(P=0.000),monocytes-tolymphocyte ratio MLR(P=0.000),systemic inflammatory response index SIRI(P=0.002),and systemic immune inflammation index SII(P=0.003)were statistically significant(P <0.05)。The remaining variables included body weight(P=0.812),height(P=0.482),tumor size(before neoadjuvant therapy(P=0.334),after neoadjuvant therapy(P=0.410),change during neoadjuvant therapy(P=0.867)),neutrophil N(P=0.566),lymphocyte L(P=0.814),neutrophil-tolymphocyte ratio NLR(P=0.697),Ki-67(P=0.096),BMI(P=0.964)was not significantly associated with a pathological grade of Miller-Payne grade 4-5.Finally,for the variables with significance less than 0.05 in univariate analysis,we can conclude that the platelet-tolymphocyte ratio PLR(P=0.001,95% CI: 0.638-0.886)and the systemic inflammatory response index SIRI(P=0.017,95% CI: 0.001-0.476)are statistically different based on the stepwise regression method based on the AIC criterion.Finally,the nomogram as well as the receiver working curve,ROC and calibration curve are constructed.AUC = 0.992 in the working curve of ROC subjects,and the 95%confidence interval is [0.980,1.00],which is close to 1,indicating that the model has good results.Similarly,the calibration curve can be seen that the predicted probability and the observation probability are basically distributed diagonally,which can also indicate that the model works well.Conclusion:This study found a correlation between systemic inflammatory indexes and pathological remission in neoadjuvant therapy in breast cancer patients,among which platelet/lymphocyte PLR and neutrophil* monocytes/lymphocyte SIRI were independent factors that could achieve pathological remission Miller-Payne grade 4-5 with neoadjuvant chemotherapy in breast cancer patients,and both PLR and SIRI were negatively correlated with pathological remission Miller-Payne grade 4-5.The higher the PLR and SIRI parameters,the more difficult it is for patients to achieve Miller-Payne grade 4-5 in pathological remission.Therefore,it is necessary to monitor the systemic inflammatory indexes PLR and SIRI in the treatment of neoadjuvant breast cancer patients,and PLR and SIRI indexes can be used as convenient and accurate detection methods for breast cancer patients with neoadjuvant chemotherapy.