Clinical study on the predictive value of the pan-immune inflammation value in assessing axillary lymph node status after neoadjuvant chemotherapy for breast cancer
Objective To explore the predictive role of the pan-immune inflammation value(PIV)in axillary lymph node status after neoadjuvant chemotherapy for breast cancer and construct a nomogram model.Methods A total of 330 patients treated at Zhongnan Hospital of Wuhan University from January 2017 to August 2024 were included and divided into two groups:the axillary lymph node pathological com-plete response group(ypN0 group)and the axillary lymph node metastasis group(ypN+group).Univari-ate and multivariate logistic analyses were used to progressively screen variables for the construction of a no-mogram model.The area under the receiver operating characteristic curve(AUC)and the Hosmer-Leme-show test were adopted to evaluate the discrimination and calibration of the model respectively.The net re-classification index(NRI)and the integrated discrimination improvement index(IDI)were used to assess the improvement in predictive performance after introducing the PIV indicator.Results PIV emerged as an independent influencing factor for achieving ypN0 in neoadjuvant chemotherapy[odds ratio(OR)=0.424,95%confidence interval(CI):0.220~0.801,P<0.05].The AUC of the prediction model in-corporating the PIV indicator was 0.873(95%CI:0.836-0.909).The Hosmer-Lemeshow test indicated a high consistency between the predicted and observed results(x2=4.790,P>0.05).The NRI and IDI values were 0.383 and 0.016 respectively.Conclusion The constructed nomogram model with PIV index can effectively evaluate the rate of axillary pathologic complete response.