Value of peripheral blood NLR combined with CD8+T lymphocytes in predicting recurrence of breast cancer patients after breast-conserving surgery
Objective To analyze the value of peripheral blood neutrophil to lymphocyte ratio(NLR)combined with CD8+T lymphocytes in predicting the recurrence of breast cancer patients after breast-conserving surgery.Methods A total of 106 patients with breast cancer who visited Baoji Maternal and Child Health Hospital from February 2016 to February 2019 were selected.They were(45.82±9.57)years old.The mean maximum tumor diameter was(2.3 7±0.85)cm.All the patients received breast-conserving surgery,and were followed up for 5 years.According to the recurrence situation,the patients were divided into a non-recurrence group and a recurrence group.The levels of peripheral blood CD8+,NLR's,and clinical data were compared between the recurrence group and the non-recurrence group.The factors influencing the recurrence of breast cancer after breast conserving surgery were analyzed.The values of peripheral blood CD8+,NLR,and their combination in predicting the recurrence of breast cancer after breast conserving surgery were analyzed.t test,x2 test,and Fisher exact probability method were used.The logistic regression model was used to analyzed the influencing factors.Results After 5 years'follow-up,3 of the 106 patients were lost to follow-up,and the follow-up rate was 97.17％(103/106).Of which,12 patients relapsed,and the recurrence rate was 11.65％(12/103);the remaining 91 patients did not relapse,and the recurrence rate was 88.35％(91/103).The level of peripheral blood CD8+in the recurrence group was lower than that in the non-recurrence group[(23.17±3.36)％vs.(29.45±4.23)％];the peripheral blood NLR in the recurrence group was higher than that in the non-recurrence group[(2.64±0.39)vs.(1.72±0.24)];there were statistical differences between the two groups(both P＜0.05).The proportion of the patients with lymph node metastasis in the recurrence group was higher than that in the non-recurrence group[58.33％(7/12)vs.24.18％(22/91);P＜0.05];the proportions of the patients taking postoperative full-course radiotherapy and standard chemotherapy in the recurrence group were lower than those in the non-recurrence group[25.00％(3/12)vs.93.41％(85/91)and 33.33％(3/12)vs.89.01％(81/91);both P＜0.05].The logistic regression analysis showed that peripheral blood CD8+decrease(OR=0.285,95％CI 0.125-0.647),peripheral blood NLR increase(OR=4.175,95％CI 1.835-9.796),lymph node metastasis(OR=5.013,95％CI 2.204-11.403),and postoperative full-course radiotherapy(OR=0.255,95％CI 0.112-0.579)were the influential factors for breast cancer recurrence after breast conserving surgery(all P＜0.05).The areas under the curves(AUC)of peripheral blood CD8+,NLR,and their combination in predicting breast cancer recurrence after breast preservation surgery were 0.799,0.844,and 0.905,respectively,and the AUC of the combination was higher(P＜0.05).Conclusion Peripheral blood CD8+T lymphocytes and NLR can be used to predict the recurrence of breast cancer patients after breast-conserving surgery,and the combined value is higher.
Breast cancerCD8+T lymphocytesNeutrophil to lymphocyte ratioBreast-conserving surgeryRecurrencePrediction
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