摘要
Abstract
Objective To analyze the correlation between pathological complete response(pCR)and pretreatment nutritional indicators in breast cancer patients receiving neoadjuvant chemotherapy.Method A total of 100 breast cancer patients treated with neoadjuvant chemotherapy at Beijing Friendship Hospital,Capital Medical University from January 2021 to January 2025 were selected.Nutritional indicators were measured within 7 days before chemotherapy,including the prognostic nutritional index(PNI),albumin(ALB),body mass index(BMI),lactate dehydrogenase-to-albumin ratio(LAR),neutrophil-to-albumin ratio(NPAR),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),lymphocyte-to-monocyte ratio(LMR),and systemic immune-inflammation index(SII).Based on postoperative pathological results,patients who achieved pCR were assigned to the pCR group,while those who did not were assigned to the control group.Demographic characteristics,clinical data,and pretreatment nutritional indicators were compared between the two groups.Multivariate logistic regression analysis was used to analyze factors influencing pCR,and the predictive performance of each indicator was evaluated using receiver operating characteristic curve(ROC curve).Result Postoperative pathological assessment showed that 28 patients(28.00%)achieved pCR.Significant differences were observed in molecular subtypes and Ki-67 status between the pCR and control groups(all P＜0.05).The pCR group had significantly lower pretreatment LAR,NPAR,NLR,PLR,and SII,and higher PNI and LMR compared to the control group(all P＜0.05).Multivariate Logistic regression analysis revealed that decreased PNI,elevated NPAR,elevated SII,and Ki-67≥30%were independent risk factors for failure to achieve pCR(all P＜0.05).ROC curve analysis showed that the AUC for Ki-67 status in predicting pCR was 0.670,while the combination of Ki-67 with PNI,NPAR,and SII yielded an AUC of 0.815 for predicting pCR.Conclusion The pCR rate after neoadjuvant chemotherapy in breast cancer patients is relatively low and is significantly influenced by Ki-67 status and pretreatment nutritional and inflammatory conditions.The combination of these indicators may provide valuable reference for predicting pCR.关键词
新辅助化疗/乳腺癌/病理完全缓解/营养指标/影响因素Key words
Neoadjuvant chemotherapy/Breast cancer/Pathological complete response/Nutritional indicators/Influencing factors
