乳腺癌患者血清NLR、CA199水平与诺丁汉预后指数的关系研究

Study on the relationship between serum NLR, CA199 levels and nottingham prognostic index in breast cancer patients

摘要:

目的 探讨乳腺癌患者血清中性粒细胞/淋巴细胞比值（NLR）、糖类抗原（CA199）水平、诺丁汉预后指数（NPI）之间的关系，以及在乳腺癌预后评估中的应用价值。方法 回顾性分析2017年6月—2021年6月在淮安市中医院确诊的72例乳腺癌患者的临床资料，根据NPI将患者分为低风险组（16例）、中风险组（34例）及高风险组（22例），比较3组患者血清NLR、CA199水平及NPI的差异。对患者进行24个月的随访。采用多因素一般Logistic回归模型分析导致预后不良的影响因素。绘制受试者工作特征曲线分析血清NLR、CA199水平及NPI对乳腺癌预后不良的预测价值。结果 3组血清NLR、CA199水平比较，差异均有统计学意义（P <0.05），高风险组血清NLR、CA199水平均高于低风险组和中风险组（P <0.05）。预后不良组的TNM分期、淋巴结转移、NPI、NLR及CA199水平与预后良好组比较，差异均有统计学意义（P <0.05）。多因素一般Logistic回归分析结果显示，TNM分期晚期、淋巴结发生转移、高NPI、高NLR和高CA199水平是乳腺癌患者预后不良的独立危险因素（P <0.05）。血清NLR、CA199、NPI三者联合预测乳腺癌患者预后不良的曲线下面积为0.922（95% CI：0.812，0.999），敏感性为86.7%（95% CI：0.695，1.000），特异性为98.2%（95% CI：0.948，1.000）。结论 乳腺癌患者的血清NLR、CA199、NPI之间存在关系，可作为评估乳腺癌预后的有用工具。

Abstract:

Objective To investigate the correlation between serum neutrophil-to-lymphocyte ratio (NLR) and carbohydrate antigen 199 (CA199) levels with the Nottingham Prognostic Index (NPI) in breast cancer patients, in order to assess the applicative value of these biomarkers in the prognosis of breast cancer.Methods A retrospective analysis was conducted on the clinical data of 72 breast cancer patients diagnosed at Huai'an Traditional Chinese Medicine Hospital from June 2017 to June 2021. Patients were divided into three groups based on the NPI index, and the correlation between serum NLR and CA199 levels with NPI scores was compared. Additionally, a 24 month follow-up analysis was performed to identify risk factors leading to poor prognosis. The predictive value of serum NLR and CA199 levels for poor prognosis in breast cancer was analyzed using the receiver operating characteristic (ROC) curve.Results Significant differences in serum NLR and CA199 levels were found among the three groups (P < 0.05). The high-risk group had higher serum NLR and CA199 levels compared to the low-risk and medium-risk groups (P < 0.05). Compared to the good prognosis group, the poor prognosis group had statistically significant differences in TNM stage, lymph node metastasis, NPI, NLR, and CA199 levels (P < 0.05). Multivariate logistic regression analysis showed that advanced TNM stage, lymph node metastasis, high NPI, high NLR, and high CA199 levels were independent risk factors for poor prognosis in breast cancer patients (P < 0.05). The area under the ROC curve (AUC) for the combined prediction of poor prognosis using serum NLR, CA199 levels, and NPI was 0.922 (95% CI: 0.812, 0.999), with a sensitivity of 86.7% (95% CI: 0.695, 1.000) and specificity of 98.2% (95% CI: 0.948, 1.000).Conclusion There is a significant correlation between serum NLR and CA199 levels with NPI scores in breast cancer patients, indicating their utility as tools for assessing the prognosis of breast cancer.