Research Of Peripheral Blood Neutrophil And Lymphocyte Ratio For The Evaluation Of The Efficacy And Prognosis Of Neoadjuvant Chemotherapy In Hormone Receptor-positive Breast Cancer

Purposes:Neoadjuvant chemotherapy(NAC)is one of the standard treatment options for locally advanced breast cancer,which allows patients to have surgery and improve breast-conserving rate.This study was designed to explore the differential inflammatory/immune biomarkers in peripheral blood including Neutrophil count(NC),Lymphocyte count(LC),and Neutrophil/lymphocyte ratio(NLR)in evaluation of the efficacy and prognosis of neoadjuvant chemotherapy for hormone receptor-positive breast cancer patients.Materials and Methods:The clinical data of 122 breast cancer patients who received neoadjuvant chemotherapy with hormone receptor-positive from the breast center of the First Affiliated Hospital of Nanjing Medical University from January 2008 to March 2015 were retrospectively analyzed.Chi-square test was used for correlation between different inflammatory/immune biomarkers in peripheral blood and clinicopathological factors as well as pathological complete response(pCR)after neoadjuvant chemotherapy.Kaplan-Meier survival analysis was used to explore the relationship between different inflammatory/immune biomarkers and disease free survival(DFS).Univariate and multivariate COX regression analysis was applied to evaluate clinical pathological factors and effects of different inflammatory/immune biomarkers in peripheral blood on DFS.Results:1..The chi-square test results indicated that patients with low NC(≤2.040 × 109/L)before treatment had a higher pCR ratio than those with high NC(>2.040 × 109/L)(P=0.024).Patients with low NLR(≤2.003)before treatment had a higher pCR ratio than those with high NLR(>2.003)(P = 0.028).2.Kaplan-Meier survival analysis showed that LC and NC were not associated with DFS before treatment,and patients with low NLR before treatment had longer DFS than those with higher NLR(P =0.0021).3.One-way COX regression analysis indicated that Progesterone receptor(PR)status was positively correlated with DFS in patients.The hazard ratio(HR)was 0.411,95%confidence interval(95%Confidence Intervals,95%).CI)was 0.183-0.924,P =0.032.Patients with a high Ki67 proliferation index had significantly shorter DFS(HR:1.266,95%CI:1.038-1.545,P-0.020).Patients with high NLR had a poor prognosis(HR:3.497,95%CI:1.198-8.167,P = 0.004).4.Multivariate COX regression analysis showed that patients with high Ki67 proliferation index had significantly shorter DFS(HR:1.376,95%CI:1.080-1.753,P=0.010),while patients with high NLR had a poorer prognosis(HR:3.719).,95%CI:1.174-12.280,P=0.026).Conclusion:1.Preoperative low NLR and low NC can predict the efficacy of NAC in patients with hormone receptor-positive breast cancer.2.Ki67 index and NLR can be used as independent risk factors for postoperative recurrence in hormone receptor-positive breast cancer patients.