Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Short- and Long-Term Mortality in Breast Cancer Patients
Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Short- and Long-Term Mortality in Breast Cancer Patients
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DOI：
10.1245/s10434-011-1814-0
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发表时间：
2012-01-01
影响因子：
3.7
通讯作者：
Widmann, Warren D.
中科院分区：
文献类型：
--
作者：
Azab, Basem;Bhatt, Vijaya R.;Widmann, Warren D.
中性粒细胞/淋巴细胞比率(NLR)是结直肠癌、胃癌、肝细胞癌、胰腺癌和肺癌患者死亡率的有力预测因子。到目前为止，NLR预测乳腺癌患者死亡率的有效性还没有被研究过。因此，我们研究的目的是确定NLR是否可以预测乳腺癌患者的短期和长期死亡率。我们的观察性研究使用了2004年1月至2006年12月期间在斯塔滕岛大学医院接受治疗的未选定的乳腺癌患者队列。共有316名患者在化疗前记录了不同的白细胞计数。生存状态从我们的癌症登记和社会保障死亡指数中检索。按NLR四分位数分层的生存分析用于评估NLR的预测价值。与NLR最低四分位数(NLR<；1.8)相比，NLR最高四分位数(NLR>；3.3)患者的1年(16%比0%)和五年(44%比13%)死亡率更高(P<；.0001)。那些在NLR四分位数最高的人在统计上明显年龄较大，癌症分期更晚期。在调整了影响死亡率和/或NLR的因素后(使用两个多变量模型)，NLR水平和GT；3.3仍然是两个模型中死亡率的独立显著预测因素(风险比3.13，P=0.01)(风险比4.09，P=0.002)。NLR是NLR和GT；3.3乳腺癌患者短期和长期死亡率的独立预测因素。我们建议进行前瞻性研究，以评估NLR作为一种简单的乳腺癌预后检测方法。
The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with colorectal, gastric, hepatocellular, pancreatic, and lung cancer. To date, the utility of NLR to predict mortality in breast cancer patients has not been studied. Therefore, the aim of our study was to determine whether the NLR is predictive of short- and long-term mortality in breast cancer patients.Our observational study used an unselected cohort of breast cancer patients treated at the Staten Island University Hospital between January 2004 and December 2006. A total of 316 patients had a differential leukocyte count recorded prior to chemotherapy. Survival status was retrieved from our cancer registry and Social Security death index. Survival analysis, stratified by NLR quartiles, was used to evaluate the predictive value of NLR.Patients in the highest NLR quartile (NLR > 3.3) had higher 1-year (16% vs 0%) and 5-year (44% vs 13%) mortality rates compared with those in the lowest quartile (NLR < 1.8) (P < .0001). Those in the highest NLR quartile were statistically significantly older and had more advanced stages of cancer. After adjusting for the factors affecting the mortality and/or NLR (using two multivariate models), NLR level > 3.3 remained an independent significant predictor of mortality in both models (hazard ratio 3.13, P = .01) (hazard ratio 4.09, P = .002).NLR is an independent predictor of short- and long-term mortality in breast cancer patients with NLR > 3.3. We suggest prospective studies to evaluate the NLR as a simple prognostic test for breast cancer.