The Evaluation Of Neutrophil-to-Lymphocyte Ratio/Derive Neutrophil-to-Lymphocyte Ratio For The Benefits Of Neoadjuvant Chemotherapy To Breast Carcinoma

Objective:Neoadjuvant chemotherapy becomes a conventional treatment for many malignant tumors.Accurate evaluation of its efficacy plays a crucial role in the process of tumor treatment.At present,studies have shown that the formation and progression of tumors are related to inflammatory reaction to some extent.As a marker of inflammatory response,whether NLR and d NLR can prognosticate the effect of neoadjuvant chemotherapy is still controversial.The purpose of this study is to explore the prognostic value of NLR and d NLR to the therapeutic effect of neoadjuvant chemotherapy on breast cancer,including the correlation with different clinical factors.Materials and Methods:From January 2014 to December 2017,a total of 50 breast cancer patients who received neoadjuvant chemotherapy in galactophore department of affiliated dayi hospital of Shanxi Medical University were selected according to the inclusion criteria.The patient's clinical data,pathological data and blood routine data were collected.We evaluated the prognostic value of NLR/d NLR and the correlation between NLR/d NLR and different clinical factors applying methods such as receiver operating characteristics(ROC)analysis,Kruskal-Wallis test,Spearman's correlation coefficient.Results: In this study,20% of the patients underwent breast conserving surgery after neoadjuvant chemotherapy and 8% of the patients were selected for breast reconstruction.After neoadjuvant chemotherapy,p CR accounted for 20%.In single factor analysis,there was a positive correlation between the level of NLR/d NLR and the histological grade score of the tumor.There was a significant difference in the NLR/d NLR level between the response group and the non-response group.There was also significant difference in the level of NLR and d NLR between the PR positive group and the PR negative group.However,there was no significant difference between NLR/d NLR and pathological type,Miller-Payne score or pathological staging.To determine the best segmentation based on Youden index,the area under the NLR/d NLR curve were greater than 0.5,and the best segmentation points,two of the same sensitivity,but the specificity of d NLR is higher than NLR.Conclusion:In patients with breast cancer,high NLR/d NLR levels may indicate low level of differentiation.The elevated NLR/d NLR level before the operation may prognosticate that the effect of neoadjuvant chemotherapy on breast cancer patients is worse.The d NLR is more sensitive than NLR in the prognostication of neoadjuvant chemotherapy.