【作者】 杜冰；

【导师】 李丽；

【作者基本信息】 大连医科大学 ， 肿瘤学， 2014， 硕士

【摘要】 目的：近年来，研究发现，肿瘤的发生、发展与炎症密切相关，其中中性粒细胞-淋巴细胞比值（Neutrophil-to-Lymphocyte Ratio,NLR）被认为与多种肿瘤包括直肠癌、肺癌、胃癌、肝癌的预后相关。目前，关于NLR与乳腺癌预后的研究较少，本文就术前NLR与乳腺癌患者的预后及术后病理及临床各因素的关系进行研究，评价NLR与乳腺癌患者临床各因素及预后的关系。方法：回顾性分析2006年1月至2008年1月，大连医科大学附属第一医院收治的经手术治疗的乳腺癌患者203例，统计患者术前最后一次血常规资料。记录年龄、中性粒细胞计数（N）、淋巴细胞计数（L）、NLR及术后病理资料，进行统计学分析。根据ROC曲线，兼顾敏感性及特异性，选取NLR=1.81为临界值，将患者分为低NLR组（NLR＜1.81﹚及高NLR组（NLR＞1.81）。分析两组患者临床病理因素、无病生存期及总生存时间之间的关系。所有数据均采用spss17.0软件进行统计分析检验标准定为P＜0.05.NLR为中性粒细胞绝对值与淋巴细胞绝对值之比。结果：分析NLR与肿瘤术后分期的关系，发现随着分期越晚，血常规中的NLR值越高，且差异有统计学意义（P＜0.001﹚；分析术前NLR与临床及术后病理各因素之间的关系，发现NLR与病理分期（P＜0.001）及肿瘤分级（P＜0.05）显著相关。203例患者中，NLR＜1.81组中复发与未复发患者比例分别为15%、34%；NLR＞1.81组中其中复发与未复发患者比例分别为34%、14%。差异具有统计学意义﹙P＜0.001﹚；用Kaplan-Meier方法绘制无病生存曲线，Log-rank检验显示差异有统计学意义﹙P＜0.001﹚。本研究中203例乳腺癌患者5年生存率为80.6%，其中NLR＞1.81组80.2%；NLR＜1.81组88.1%。差异有统计学意义（P=0.007）总结1.乳腺癌患者术前更高的NLR可能预示着更高的术后分期。2.术前NLR=1.81作为判断乳腺癌患者的预后截断值，术前NLR＞1.81的患者预后比NLR＜1.81的患者预后差。3.术前NLR有望成为乳腺癌患者预后的判断指标。更多还原

【Abstract】 Objective: In recent years, studies have found that tumor occurrence anddevelopment is closely related to inflammation, including neutrophils-lymphocyteratio (Neutrophil-to-Lymphocyte Ratio, NLR) is considered with a variety of tumors,including colorectal cancer, lung cancer, stomach cancer, liver cancer prognosis.Currently, research on NLR and prognosis of breast cancer is less, this article on therelationship between preoperative and postoperative NLR pathology and clinicalprognostic factors in patients with breast cancer study, the relationship between NLRand clinical evaluation of patients with breast cancer prognostic factors.Methods: A retrospective analysis from January2006to January2008,203casesof breast cancer patients treated in the first Affiliated Hospital of Dalian MedicalUniversity after surgery, the patient before surgery last blood statistical data. Recordage, white blood cell count (WBC), neutrophil count (N), lymphocyte count (L), NLRand postoperative pathological data were statistically analyzed. According to the ROCcurve, taking into account the sensitivity and specificity, select NLR=1.81as thecritical value, the patients were divided into low NLR group (NLR <1.81) and highNLR group (NLR>1.81). Two groups of patients analyzed clinicopathological factors,the relationship between progression-free survival and overall survival between. Alldata were statistically analyzed using spss17software testing standards set at P<0.05.NLR as the ratio of neutrophils and lymphocytes.Results: The analysis of the relationship between NLR and tumor staging surgery,found that with the later stages, the higher the blood of the NLR value, and thedifference was statistically significant (P <0.001); prior to analysis and clinical preoperative and postoperative pathological NLR the relationship between the factorsfound NLR and pathological stage (P <0.001) and tumor grade (P <0.05) weresignificantly correlated.203cases of patients relapse and the proportion of patientswithout recurrence were15%,34%; NLR>1.81, the number of which has not relapsedand relapsed patients were34%,14%. The difference was statistically significant (P<0.001); progression-free survival curves plotted Kaplan-Meier method, Log-rank testshowed statistically significant (P <0.001). In this study,203cases of breast cancer5-year survival rate was80.6%, which NLR>1.81group80.2%; NLR <1.81group88.1%. The difference was statistically significant (P=0.007)Summary1A preoperative breast cancer patients indicates higher NLR higher postoperativestaging.2preoperative NLR=1.81as the prognosis of breast cancer patients to determinethe cutoff value, preoperative NLR>1.81prognosis than NLR <1.81in patients withpoor prognosis.3Preoperative NLR can be used as prognostic breast cancer patients.更多还原