HER2陽性乳癌患者における術前化学療法開始前の総リンパ球数は予後予測の指標となり得る

Purpose : Several studies have shown that peripheral hematologic parameters, such as the absolute lymphocyte count（ALC）and neutrophil to lymphocyte ratio（NLR）can predict the prognosis for malignant tumor. We investigated the relation of these parameter and prognosis before neoadjuvant chemotherapy for human epidermal growth factor receptor-２（HER２）-positive breast cancer patients.
Methods : From April ２００９ to March ２０１９, ８５ patients diagnosed with HER２‐positive breast cancer and treated with trastuzumab-based neoadjuvant chemotherapy were included in this retrospective cohort study. The optimal cut-off for the NLR and ALC was identified using the receiver operating characteristic（ROC）curve analysis and Youden’s index.
Results : The median age of patients at the start of treatment was ５８．９（range ３２‐８１）years. The median follow-up time for HER２-positive breast cancer patients was ５２．０（range：９．８‐１１４．３）months. In this period, １１ patients developed recurrence. The low-ALC group showed better disease free survival than the high-ALC group（p=０．０４８２）. There was no significant difference in disease free survival between the low- and high-NLR groups.
Conclusion : ALC before neoadjuvant chemotherapy may be a predictor of prolonged disease free survival in HER２‐positive breast cancer patients.