PDF(Pubmed)
Abstract：
OBJECTIVE: Higher neutrophil-lymphocyte ratio (NLRs) indicate a pro-inflammatory state and are associated with poor survival. Conversely, higher albumin-globulin ratio (AGRs) may be associated with improved prognosis. We aimed to investigate the association between NLR and AGR and prognosis and survival in patients with breast cancer.
METHODS: This retrospective study included all patients with stage I-III breast cancer between 2011 and 2017 in Singapore General Hospital and National Cancer Center Singapore. Multivariate logistic regression analysis of NLR, AGR, age, stage, grade, and subtype was performed. Survival data between groups were compared using Cox regression analysis and log-rank tests.
RESULTS: A total of 1,188 patients were included, of whom 323 received neoadjuvant chemotherapy (NACT) and 865 underwent upfront surgery. In patients who underwent NACT, a higher AGR was significantly associated with a higher pCR rate (cut-off > 1.28; odds ratio [OR], 2.03; 95% confidence interval [CI], 1.13-3.74; p = 0.020), better DFS (cut off > 1.55; hazard ratio [HR], 0.37; 95% CI, 0.16-0.85; p = 0.019), and better CSS (cut off > 1.46; HR, 0.39; 95% CI, 0.17-0.92; p = 0.031). Higher NLR was significantly associated with worse DFS (cut off > 4.09; HR, 1.77; 95% CI, 1.07-2.91; p = 0.026) and worse CSS (cut off > 4.09; HR, 1.98; 95% CI, 1.11-3.53; p = 0.021). In patients who underwent upfront surgery, higher AGR correlated with significantly better OS (cut off > 1.17; HR, 0.54; 95% CI, 0.36-0.82; p = 0.004) and higher NLR correlated with worse OS (cut off > 2.38; HR, 1.63; 95% CI, 1.09-2.44; p = 0.018).
CONCLUSIONS: NLR and AGR are useful in predicting the response to NACT as well as prognosis of patients with breast cancer. Further studies are needed to explore their value in clinical decision making.
METHODS: This retrospective study included all patients with stage I-III breast cancer between 2011 and 2017 in Singapore General Hospital and National Cancer Center Singapore. Multivariate logistic regression analysis of NLR, AGR, age, stage, grade, and subtype was performed. Survival data between groups were compared using Cox regression analysis and log-rank tests.
RESULTS: A total of 1,188 patients were included, of whom 323 received neoadjuvant chemotherapy (NACT) and 865 underwent upfront surgery. In patients who underwent NACT, a higher AGR was significantly associated with a higher pCR rate (cut-off > 1.28; odds ratio [OR], 2.03; 95% confidence interval [CI], 1.13-3.74; p = 0.020), better DFS (cut off > 1.55; hazard ratio [HR], 0.37; 95% CI, 0.16-0.85; p = 0.019), and better CSS (cut off > 1.46; HR, 0.39; 95% CI, 0.17-0.92; p = 0.031). Higher NLR was significantly associated with worse DFS (cut off > 4.09; HR, 1.77; 95% CI, 1.07-2.91; p = 0.026) and worse CSS (cut off > 4.09; HR, 1.98; 95% CI, 1.11-3.53; p = 0.021). In patients who underwent upfront surgery, higher AGR correlated with significantly better OS (cut off > 1.17; HR, 0.54; 95% CI, 0.36-0.82; p = 0.004) and higher NLR correlated with worse OS (cut off > 2.38; HR, 1.63; 95% CI, 1.09-2.44; p = 0.018).
CONCLUSIONS: NLR and AGR are useful in predicting the response to NACT as well as prognosis of patients with breast cancer. Further studies are needed to explore their value in clinical decision making.
摘要：
目的：较高的中性粒细胞-淋巴细胞比率（NLR）表明促炎状态，并与低生存率相关。相反，较高的白蛋白-球蛋白比值(AGRs)可能与预后改善相关.我们旨在研究NLR和AGR与乳腺癌患者预后和生存之间的关系。
方法：这项回顾性研究纳入了2011年至2017年新加坡总医院和新加坡国家癌症中心的所有I-III期乳腺癌患者。NLR的多因素logistic回归分析，AGR,年龄,舞台,grade,和亚型进行。使用Cox回归分析和对数秩检验比较组间生存数据。
结果：共纳入1,188例患者，其中323人接受了新辅助化疗(NACT),865人接受了前期手术.在接受NACT的患者中，较高的AGR与较高的pCR率显著相关(截止值>1.28；比值比[OR]，2.03；95%置信区间[CI]，1.13-3.74；p=0.020），更好的DFS(截止>1.55；危险比[HR]，0.37；95%CI，0.16-0.85；p=0.019），和更好的CSS(截止>1.46；HR，0.39；95%CI，0.17-0.92；p=0.031）。较高的NLR与较差的DFS显著相关(截止>4.09；HR，1.77；95%CI，1.07-2.91；p=0.026）和更差的CSS（截止>4.09；HR，1.98；95%CI，1.11-3.53；p=0.021）。在接受前期手术的患者中，较高的AGR与较好的OS相关(截止值>1.17；HR，0.54；95%CI，0.36-0.82；p=0.004），较高的NLR与较差的OS相关(截止>2.38；HR，1.63；95%CI，1.09-2.44；p=0.018)。
结论：NLR和AGR可用于预测乳腺癌患者对NACT的反应以及预后。需要进一步的研究来探索它们在临床决策中的价值。
方法：这项回顾性研究纳入了2011年至2017年新加坡总医院和新加坡国家癌症中心的所有I-III期乳腺癌患者。NLR的多因素logistic回归分析，AGR,年龄,舞台,grade,和亚型进行。使用Cox回归分析和对数秩检验比较组间生存数据。
结果：共纳入1,188例患者，其中323人接受了新辅助化疗(NACT),865人接受了前期手术.在接受NACT的患者中，较高的AGR与较高的pCR率显著相关(截止值>1.28；比值比[OR]，2.03；95%置信区间[CI]，1.13-3.74；p=0.020），更好的DFS(截止>1.55；危险比[HR]，0.37；95%CI，0.16-0.85；p=0.019），和更好的CSS(截止>1.46；HR，0.39；95%CI，0.17-0.92；p=0.031）。较高的NLR与较差的DFS显著相关(截止>4.09；HR，1.77；95%CI，1.07-2.91；p=0.026）和更差的CSS（截止>4.09；HR，1.98；95%CI，1.11-3.53；p=0.021）。在接受前期手术的患者中，较高的AGR与较好的OS相关(截止值>1.17；HR，0.54；95%CI，0.36-0.82；p=0.004），较高的NLR与较差的OS相关(截止>2.38；HR，1.63；95%CI，1.09-2.44；p=0.018)。
结论：NLR和AGR可用于预测乳腺癌患者对NACT的反应以及预后。需要进一步的研究来探索它们在临床决策中的价值。
