The Prognostic Value Of Inflammatory Markers On Elderly Breast Cancer

Objective: To investigate the predictive value of inflammatory markers on prognosis of elderly breast cancer patients.Methods: A retrospective study was conducted on 260 elderly breast cancer patients aged ≥65 years who were treated in the Affiliated Cancer Hospital of Guangxi Medical University from 2003 to 2018.The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)and Systemic inflammation index(SII)were determined by ROC curve divided into high and low groups,respectively.Kaplan-Meier method was used to compare the overall survival(OS)and disease free survival(DFS)of the high and low inflammation markers group and other clinical indicators.Cox regression model was used to analyze independent prognosis predictors of elderly breast cancer patients.Results: The best cut off values of NLR,PLR and SII were 2.04,185.27 and429.06.Kaplan Meier analysis showed that age(p=0.018),histopathological grade(p=0.037),clinical stage(p<0.001),molecular typing(p=0.006),radiotherapy(p=0.013),NLR(p<0.001),PLR(p=0.006)and SII(p< 0.001)were the influencing factors of DFS in elderly breast cancer patients.Age(p=0.013),clinical stage(p=0.017),molecular typing(p<0.001),endocrine therapy(p=0.024),NLR(p<0.001)and SII(p=0.047)were the influencing factors of OS in elderly breast cancer patients.Cox regression model analysis showed that clinical stage(HR = 5.122,95% CI 1.596～16.440,p= 0.006),NLR(HR = 2.340,95% CI 1.089～5.028,p= 0.029)and SII(HR = 3.132,95% CI1.263～7.766,p= 0.014)were independent prognostic factors for DFS in elderly breast cancer patients;Age(HR=4.893,95%CI 1.911～12.532,p=0.001),clinical stage(HR=3.215,95%CI 1.030～10.034,p=0.017),HER2 overexpression(HR=4.017,95%CI1.280～12.563,p=0.017),TNBC(HR=5.178,95%CI1.850～14.532,p=0.002),NLR(HR=2.408,95%CI 1.417～4.092,p= 0.001)were independent prognostic factors for OS in elderly breast cancer patients.Older age,late stage,TNBC,high NLR group had higher risk of death.Conclusion: NLR,PLR and SII can be used as a simple biomarker to predict the prognosis of elderly breast cancer patients.NLR and SII are independent prognostic factors of DFS in elderly breast cancer patients.High NLR and SII group have higher risk of recurrence,NLR is independent prognostic factor of OS in elderly breast cancer patients,and high NLR group has higher risk of death.