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冯帆,王一刻,张峰.术前外周血淋巴细胞比值对早期乳腺癌患者非前哨淋巴结转移的预测分析[J].浙江中西医结合杂志,2021,31(6):
术前外周血淋巴细胞比值对早期乳腺癌患者非前哨淋巴结转移的预测分析
Study of the predictive value of pre-treatment neutrophil-lymphocyte ratio for non sentinel lymph node metastasis in early breast cancer patients.
投稿时间:2020-12-07  修订日期:2021-04-30
DOI:
中文关键词:  乳腺癌  外周血淋巴细胞比值  前哨淋巴结活检  非前哨淋巴结转移
英文关键词:Breast Cancer  Pre-Treatment Neutrophil-Lymphocyte Ratio  Sentinel Lymph Node Biopsy  non-Sentinel Lymph Node Metastasis
基金项目:
作者单位E-mail
冯帆 杭州市妇产科医院 646303980@qq.com 
王一刻 浙江大学医学院附属妇产科医院  
张峰 杭州市妇产科医院 zhang3772@qq.com 
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中文摘要:
      目的 研究术前外周血淋巴细胞比值对早期乳腺癌患者非前哨淋巴结转移的预测价值。方法 回顾性选取杭州市妇产科医院及浙江大学医学院附属妇产科医院乳腺科2014年1月至2020年1月行前哨淋巴结活检的临床早期乳腺癌患者443例,将其中有前哨淋巴结转移的189例患者根据是否有非前哨淋巴结转移把研究对象分为转移组和未转移组,分析术前外周血淋巴细胞比值与非前哨淋巴结转移的相关性,并分析其他临床病理特征对非前哨淋巴结的预测价值。结果 非前哨淋巴结转移组共有99例,未转移组有90例。单因素分析显示肿瘤大小(p=0.006)、前哨淋巴结转移数量(p=0.026)、脉管浸润(p=0.003)和术前外周血淋巴细胞比值(p=0.003)是非前哨淋巴结转移的影响因素。多因素分析显示脉管浸润(p=0.016, OR:5.057, 95% CI:1.351-18.927)、肿瘤大小(p=0.038, OR:1.952, 95% CI:1.038 to 3.672)、术前NLR(p < 0.001, OR:2.213, 95% CI:1.426 to 3.432) 对于预测早期乳腺癌非前哨淋巴结转移具有统计学意义。术前外周血淋巴细胞比值的受试者工作特征曲线下面积为0.668(95%CI, 0.592-0.744),p < 0.001,最佳截断值2.7,敏感度62.6%,特异度87.8%。结论 术前外周血淋巴细胞比值是乳腺癌非前哨淋巴结转移的有效预测因素。
英文摘要:
      Objective To explore the predictive value of pre-treatment neutrophil-lymphocyte ratio for non sentinel lymph node metastasis in early breast cancer patients. Methods The records of 443 consecutive early Breast Cancer Patients who undergone sentinel lymph node biopsy at Department of breast from Hangzhou Women’s Hospital and Women"s Hospital School Of Medicine Zhejiang University between January 2014 to the January 2020 were examined. All patients were divided into two groups according to the non-sentinel lymph node status and pre-treatment neutrophil-lymphocyte ratio and clinicopathology features were analyzed. Results Significant differences in tumor size (p=0.006), positive number of SLN(p=0.026), lymphovascular invasion (p=0.003) and pre-treatment neutrophil-lymphocyte ratio(p=0.003) were observed between two groups. Multivariate analysis indicated that lymphovascular invasion (p=0.016, OR:5.057, 95% CI:1.351-18.927), tumor size(p=0.038, OR:1.952, 95% CI:1.038 to 3.672) and 术前NLR(p < 0.001, OR:2.213, 95% CI:1.426 to 3.432) were independent predictors of sentinel lymph node metastasis. The AUC for neutrophil-lymphocyte ratio was 0.668(95%CI, 0.592-0.744) with an optimal cut-off of 2.7, a sensitivity of 62.6% and a specificity of 87.8%. Conclusion Pre-treatment neutrophil-lymphocyte ratio is a effective predictor of non sentinel lymph node metastasis.
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