Diagnostic Value Of Neutrophil-to-Lymphocyte Ratio,D-Dimer And CA153 In Postoperative Recurrent And Metastatic Breast Cancer

Purpose: To assess the value of neutrophil-to-lymphocyte ratio（NLR）,D-dimer and carbohydrate antigen 153（CA153）for diagnosing postoperative recurrence and metastasis of breast cancer.Method: Retrospective analysis of 252 breast cancer patients who received standard surgical treatment from August 2008 to August 2018 showed that among all patients,131 patients were diagnosed by our hospital with recurrence or distant metastasis within 10 years after operation,while the remaining 121 patients had no recurrence or metastasis in the regular outpatient reexamination in our hospital.Retrospective comparison of hematological parameters and clinicopathological characteristics was performed between the 2 groups,as well as assessment of the correlation between these data of the 131 recurrent and metastatic breast cancer patients.Results: 1)Lymph node metastasis,higher TNM staging and histologic grade were correlated with recurrence and metastasis of breast cancer（P<0.05）.2)There were statistical differences in absolute neutrophil count（ANC）,absolute lymphocyte count（ALC）,CEA（carcino-embryonic antigen）,CA153,D-dimer,NLR,platelet-to-lymphocyte ratio（PLR）and monocyte-to-lymphocyte ratio（MLR）between recurrent and metastatic group and control group（P<0.05）.3)Logistic regression analysis showed that CA153,D-dimer,NLR and TNM staging were independent risk factors for recurrence and metastasis of breast cancer（p<0.05）and combined detection with the NLR,D-dimer and CA153 had good diagnostic value with highest area under the curve（AUC）which is 0.913.4)For recurrent and metastatic group,high NLR,D-dimer and CA153 were significantly associated with multiple sites with recurrence and metastasis,lymph node metastasis and higher TNM staging（P<0.05）.5)The level of CA153 in patients with bone metastasis was higher（P<0.05）;the level of D-dimer in patients with lung metastasis was higher（P<0.05）.With the time-lapse of operation,the possibility of liver metastases gradually decreased,while that of chest wall recurrence gradually increased（P<0.05）.Conclusion: Monitoring of postoperative NLR,D-dimer and CA153 is a convenient,practical method for diagnosing recurrence and metastasis of breast cancer.Furthermore,combined detection with the CA153,D-dimer and NLR was proved to be the best scheme for diagnosis.Meanwhile,they were also good indicators to predict the recurrent and metastatic sites and multiple sites with recurrence and metastasis.