血小板和淋巴细胞计数对乳腺癌患者预后的预测价值
Significance of platelet and lymphocyte counts for predicting the prognosis of patients with breast cancer

目的 分析术前外周血淋巴细胞计数、血小板计数和血小板/淋巴细胞比值（PLR）与浸润性乳腺癌可手术患者预后的关系。方法 回顾性分析2009年1月至2010年12月于上海交通大学医学院附属瑞金医院诊断为浸润性乳腺癌接受手术并行辅助治疗的487例女性患者。采用Kaplan-Meier曲线法进行生存分析，并采用log-rank检验比较其无病生存率和总生存率。多因素分析采用COX比例风险模型。结果 随访时间中位数为55个月。Kaplan-Meier生存曲线分析显示，高和低淋巴细胞计数组或血小板计数组的乳腺癌患者的5年无病生存率和总生存率差异无统计学意义。高PLR（≥110.16）组的患者5年无病生存率为81.2%，显著低于低PLR（<110.16）组患者的87.1%（P=0.021）。高PLR组的患者5年总生存率与低PLR组间差异无统计学意义（89.8%比93.1%，P=0.273）。COX比例风险模型多因素分析显示，高PLR组的患者无病生存时间显著低于低PLR组的患者（HR=1.796，95%CI=1.116~2892，P=0.016）。结论 PLR是浸润性乳腺癌患者无病生存率的独立预测因素，而外周血淋巴细胞计数和血小板计数与乳腺癌的预后无显著相关性。
： Objective To analyze the correlation between preoperative platelet count, lymphocyte count and platelet to lymphocyte ratio (PLR) in peripheral blood and the prognosis in operable patients with invasive breast cancer. Methods A retrospective analysis of 487 female patients who were diagnosed with invasive breast cancer and underwent surgery and adjuvant therapies at Ruijin hospital, Shanghai Jiao Tong University School of Medicine from January 2009 to December 2010 was performed. Disease free survival (DFS) and overall survival (OS) were assessed using KaplanMeier method and compared using logrank test. Multivariate analysis employed Cox proportional hazard model. Results The median follow-up time was 55 months. KaplanMeier survival curve analysis revealed that the differences in 5year DFS and OS between patients in high platelet count and low platelet count groups or high lymphocyte count and low lymphocyte count groups were not statistically significant. Patients in the high PLR (≥110.16) group had a much lower 5year DFS compared with patients in the low PLR group (81.2% versus 87.1%, P=0.021). The differences in 5year OS between patients in the high PLR group and the low PLR (<110.16) group was not statistically significant (898% versus 931%, P=0.273). Cox proportional hazard model multivariate analysis revealed that patients in the high PLR group had a much lower DFS compared with patients in the low PLR group (HR=1.796, 95%CI=1.116-2.892, P=0.016). Conclusion PLR is an independent factor for predicting disease free survival in patients with invasive breast cancer, while platelet count and lymphocyte count in peripheral blood are not significant correlated to the prognosis of breast cancer