IL-6 联合中性粒细胞与淋巴细胞比值对 三阴性乳腺癌的预后评估价值

Value of preoperative interleukin-6 combined with neutrophillymphocyte ratio in evaluating the prognosis of triple-negative breast cancer

摘要:

目的 探究IL-6 联合中性粒细胞与淋巴细胞比值对三阴性乳腺癌预后的价值。方法 选取2013 年 1 月—2016 年5 月徐州医科大学附属医院甲乳外科收治的经术后病理确诊为三阴性乳腺癌的患者127 例。患 者均进行为期3 年的随访，根据随访结果绘制生存曲线；利用单因素和多因素回归分析筛选出影响三阴性 乳腺癌预后的独立危险因素；绘制ROC 曲线，评价各潜在指标对三阴性乳腺癌预后的影响。利用Logistic 回归模型探索联合诊断评估三阴性乳腺癌预后的可行性。结果 患者的不良预后率为14.96%。TNM 分期 [Rl ^ R=0.036（95 CI ：1.498，3.883），P =0.036]、癌胚抗原[Rl ^ R=2.151（95 CI ：1.120，4.131），P =0.000]、糖 类抗原125[Rl ^ R=1.775（95 CI ：1.073，2.937），P =0.008]、中性粒细胞与淋巴细胞比值[Rl ^ R=1.641（95 CI ： 1.279，2.105），P =0.032] 及IL-6[Rl ^ R=1.305（95 CI：1.120，1.521），P =0.017] 是三阴性乳腺癌预后的影响因素。 癌胚抗原[Rl ^ R=2.115（95 CI ：1.353，3.307），P =0.002]、中性粒细胞与淋巴细胞比值[Rl ^ R=1.851（95 CI ： 1.783，1.921），P =0.027] 及IL-6[Rl ^ R=1.344（95 CI ：1.081，1.671），P =0.018] 是影响预后的独立危险因素。 中性粒细胞与淋巴细胞比值联合IL-6 预测三阴性乳腺癌预后的AUC 最高（0.740），高于两者单独诊断的 AUC。结论 中性粒细胞与淋巴细胞比值和IL-6 对三阴性乳腺癌的预后具有一定的评估价值，两者联合诊 断可作为三阴性乳腺癌预后的诊断指标。

Abstract:

Objective To explore the value of interleukin-6 combined with neutrophil-lymphocyte ratio in evaluating the prognosis of triple-negative breast cancer. Methods One hundred and twenty-seven patients with triple-negative breast cancer admitted to our hospital from January 2013 to May 2016 were enrolled for a 3-year follow-up. Survival curves were drawn based on follow-up results. Single-factor and multivariate regression analysis were used to screen out independent risk factors affecting the prognosis of triple-negative breast cancer. ROC curves were established to evaluate the predictive power of each potential indicator for the prognosis of triple-negative breast cancer. Logistic regression model was used to establish a joint diagnosis, and the feasibility of combined diagnosis to evaluate the prognosis of triple-negative breast cancer was explored. Results The patient’s poor prognosis rate was 14.96%; TNM stage [Rl ^ R = 0.036 (95 CI: 1.498, 3.883), P = 0.036], CEA [Rl ^ R = 2.151 (95 CI: 1.120, 4.131), P = 0.000], Ca 125 [Rl ^ R = 1.775 (95 CI: 1.073, 2.937), P = 0.008], NLR [Rl ^ R = 1.641 (95 CI: 1.279, 2.105), P = 0.032] and IL-6 [Rl ^ R = 1.305 (95 CI: 1.120, 1.521), P = 0.017] are independent risk factors for prognosis; CEA [Rl ^ R = 2.115 (95 CI: 1.353, 3.307), P = 0.002], NLR [Rl ^ R = 1.851 (95 CI: 1.783, 1.921), P = 0.027] and IL-6 [Rl ^ R = 1.344 (95 CI: 1.081, 1.671), P = 0.018] were independent risk factors for prognosis. The ratio of neutrophils to lymphocytes combined with IL-6 was the highest (0.740) in predicting the prognosis of triple negative breast cancer, which was higher than the AUC diagnosed separately. Conclusions NLR and IL-6 have appraisal value for the prognosis of triple-negative breast cancer, and the combined diagnosis can be used as a diagnostic indicator for the prognosis of triple-negative breast cancer.