Predictive Value Of SII On Efficacy Of Neoadjuvant Chemotherapy And Prognosis In Breast Cancer

Objectives: This study aims to explore the Predictive value of systemic immune-inflammation index(SII)on pathological complete response and prognosis in breast cancer patients with different molecular types,in order to provide guidance for accurate medical decisions.Methods: This study collected the clinicopathological data of 1242 female breast cancer patients who underwent 6-8 cycles of NAC and surgery in Yunnan Cancer Hospital from January 2014 to December 2021.The primary endpoints were p CR,and the secondary endpoint was overall survival(OS).By plotting the receiver operating characteristic curve(ROC)to determine the optimal cut-off value of pre-SII(SII before NAC),SII2(SII after 2-cycle NAC),SII4(SII after 4-cycle NAC),post-SII(SII after 6-cycle NAC)in overall breast cancer patients and breast cancer patients with different molecular types,and divided the patients into two groups of the high-level group and the low-level group according to the cut-off value.The Chi-square test or Fisher’s exact test was used to analyze the correlation between SII,mass size,lymph node metastasis and other clinical features and p CR in breast cancer patients,and the meaningful indicators of univariate analysis were incorporated into the binary logistic regression model for multivariate analysis to explore whether SII is an independent predictor of p CR.Univariate and multivariate Cox regression analysis was used to explore whether SII,mass size,lymph node metastasis,and other clinical features were independent predictors of OS.Results:1.In this study,341(27.5%)patients achieved p CR,with the highest p CR rate being HER-2 positive(48.3%),followed by triple-negative breast cancer(TNBC)patients(31.5%).2.In overall breast cancer,the ROC curve analysis showed that the area under curve(AUC)of pre-SII,SII2,SII4 and post-SII is 0.6,0.565,0.570 and 0.552,respectively,and binary logistic regression analysis showed that pre-SII was independent predictors of p CR,and lower pre-SII increased the probability of p CR.3.In the subgroup analysis,the ROC curve showed that in TNBC patients,the area under the curve of pre-SII,SII2,SII4 and post-SII is 0.720,0.578,0.586,0.573,respectively,multivariate analysis showed that pre-SII was an independent predictor of p CR,and low pre-SII was associated with higher p CR rate;in HER-2-positive breast cancer,the ROC curve analysis showed that the area under the curve of pre-SII,SII2,SII4 and post-SII is 0.619,0.576,0.562,0.573,respectively,and multivariate analysis showed that pre-SII was an independent predictor of p CR and was negatively correlated with p CR;in patients with Luminal-type breast cancer,ROC curve analysis showed that SII had few predictive value for p CR.4.Univariate and multivariate Cox regression analysis showed that no correlation between SII and OS was found.Conclusions: 1.Our study suggested that pre-SII was an independent predictor of p CR,and low pre-SII was associated with higher rates of p CR.2.Subgroup analysis confirmed the predictive value of pre-SII for p CR in TNBC populations and patients with HER-2-positive breast cancer.As an objective,simple and inexpensive laboratory indicator,pre-SII may be a potential indicator that can be used to predict p CR in breast cancer patients,especially in TNBC population.