Abstract
It has been reported that the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte
ratio (PLR) and lymphocyte to monocyte ratio (LMR), as well as systemic inflammation
response index (SIRI), are closely related with overall survival (OS) in breast cancer
patients. However, which one is the optimal indicator is vague. This study incorporates
280 breast cancer patients who received NACT. A cut-off value of LMR, PLR, SIRI and
NLR is determined by Youden index. The Pearson's X2 test or Fisher's exact test is applied to compare the correlation of different clinicopathologic
characteristics divided by SIRI. The K-M survival curves and log-rank test were applied
to determine OS. Univariate and multivariable analysis are explored by the Cox regression
model. We apply the Z test to contrast the prognostic capacity of SIRI, LMR, PLR,
and NLR. At the meanwhile, we construct the nomogram based on the results of multivariable
analysis. All enrolled cases are divided into two parts by pretreatment SIRI (cut-off
value = 0.52). Compared to high pre-treatment SIRI, high pre-treatment NLR and clinical
T3 + T4 stage, the low pre-treatment SIRI, low pretreatment NLR and clinical T1 + T2
stage had longer OS time. The Z test showed that the SIRI group had bigger AUC than
LMR and PLR, and the difference is statistically significant. The ability of nomogram,
based on pretreatment SIRI, pre-treatment NLR and clinical T stage, to predict the
3-year, 5-year, and 8-year overall survival rates of breast malignant tumor patients
is better than clinical TNM stage. Pre-treatment SIRI was a more crucial and integral
prognostic index for breast malignant tumor patients receiving NACT. It could be helpful
for doctors to predict the prognosis of breast malignant tumor patients and to evaluate
the treatment status of patients.
Keywords
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Article Info
Publication History
Published online: March 21, 2022
Accepted:
March 18,
2022
Received in revised form:
March 14,
2022
Received:
October 12,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
