Abstract: Objective　To evaluate the clinical value of neutrophil-to-lymphocyte ratio （NLR） and platelet-to-lymphocyte ratio （PLR） in predicting the recurrence and metastasis of breast cancer,and to explore influencing factors of the prognosis of patients with breast cancer.Methods　The clinical data of 154 patients with primary invasive breast cancer （patients group） who underwent surgery in Yangpu Hospital,Tongji University from 2007 to 2010 were retrospectively analyzed,and the relationship between PLR,NLR and different clinical features before surgery was analyzed,and the ROC curve of NLR and PLR in predicting recurrence and metastasis of breast cancer was drawn,Kaplan-Meier method was used to draw survival curves,and Cox regression model was used to analyze influencing factors of the prognosis of patients with breast cancer.45 patients who underwent benign breast surgery at the same period were selected as the control group.Results　During the median follow-up of 80 months of patients in patients group,a total of 15 patients died,19 patients had recurrence and metastasis.NLR and PLR of peripheral blood before surgery in patients group were higher than those in control group （P<0.05）.There was significant difference in NLR among patients with different pathological types and with or without lymphatic metastasis in patients group （P<0.05）.There was significant difference in PLR among patients with different ages and with or without lymphatic metastasis in patients group （P<0.05）.The critical value of NLR predicting recurrence and metastasis of breast cancer was 2.56,the sensitivity and specificity were 55.4% and 86.5% respectively,and area under the curve of ROC was 0.738〔95%CI（0.657,0.818）〕;the critical value of PLR predicting recurrence and metastasis of breast cancer was 123.85,the sensitivity and specificity were 67.7% and 58.4% respectively,and area under the curve of ROC was 0.651〔95%CI（0.563,0.738）〕.There was significant difference in disease free survival curve and overall survival curve between patients with or without lymphatic metastasis （P<0.05）.Cox regression model analysis presented that recurrence and metastasis,survival condition of patients with breast cancer were not significantly influenced by and NLR and PLR （P>0.05）,lymphatic metastasis found during the operation was the independent influencing factor of breast cancer patients’ survival condition.Conclusion　Preoperative NLR and PLR can predict recurrence metastasis status,but they cannot be the effective index for predicting recurrence and metastasis and prognosis of breast cancer.

Key words: Breast neoplasms, Recurrence, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio, Prognosis

摘要： 目的　评价中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）预测乳腺癌复发转移的临床价值，探讨乳腺癌患者预后的影响因素。方法　回顾性分析2007—2010年在同济大学附属杨浦医院接受手术治疗的154例原发性浸润性乳腺癌患者（病例组）的临床资料，分析术前NLR和PLR与不同临床特征的关系，绘制NLR和PLR预测乳腺癌复发转移的ROC曲线,采用Kaplan-Meier法绘制患者生存曲线，采用Cox回归模型对乳腺癌患者预后影响因素进行分析。选择同期行良性乳腺手术的患者45例作为对照组。 结果　病例组患者中位随访时间80个月，共15例患者死亡，19例发生复发转移。病例组术前外周血NLR、PLR明显高于对照组（P<0.05）。病例组不同病理类型和有无淋巴结转移患者NLR比较，差异均有统计学意义（P<0.05）。病例组不同年龄和有无淋巴结转移患者PLR比较，差异均有统计学意义（P<0.05）。 NLR预测乳腺癌复发转移的临界值为2.56，灵敏度和特异度分别为55.4%和86.5%，ROC曲线下面积0.738〔95%CI（0.657,0.818）〕；PLR预测乳腺癌复发转移的临界值为123.85，灵敏度和特异度分别为67.7%和58.4%，ROC曲线下面积为0.651〔95%CI（0.563,0.738）〕。淋巴结转移与无淋巴结转移患者无病生存曲线和总生存曲线比较，差异有统计学意义（P<0.05）。Cox回归模型分析结果显示NLR、PLR对乳腺癌患者复发转移情况、生存情况的影响均无统计学意义（P>0.05）,术中淋巴结转移情况是乳腺癌患者生存情况的独立影响因素（P<0.05）。结论　术前NLR、PLR可预测早期乳腺癌复发转移情况，但NLR和PLR不能作为预测乳腺癌复发转移和预后的有效指标。

关键词: 乳腺肿瘤, 复发, 中性粒细胞/淋巴细胞比值, 血小板/淋巴细胞比值, 预后