Abstract
PURPOSE: Inflammation, immune system and nutritional status contribute significantly to tumorigenesis, progression and metastasis. The aim of this study was to evaluate the significance of the inflammation-immune-nutritional score (IINS) on postoperative survival and recurrence in breast cancer patients and to analyze and compare the IINS, platelet-to-lymphocyte ratio (PLR), and the prognostic nutritional index (PNI) in terms of progression-free survival (PFS) and overall survival (OS) in patients with breast cancer (BC) who underwent surgical treatment prognostic value. METHODS: We executed a retrospective investigation of the clinical information and related materials of 200 female breast cancer patients who had their first breast cancer operation at the Affiliated Hospital of Jiangnan University between January 2017 and December 2018, and the IINS was built using the sum of preoperative categorical scores for high-sensitivity C-reactive protein (hs-CRP), lymphocytes (LYM), and albumin (ALB). In our survival analysis, we graphed the survival curves employing the Kaplan-Meier method. The effectiveness of pre-operative IINS, PLR, and PNI in PFS and OS of breast cancer patients were evaluated with receiver operating characteristic (ROC) curves and Cox proportional risk regression analyses. RESULTS: The median age of the patients was 55.5 years (range 34-75 years). In progression-free survival, the areas under the IINS, PLR, and PNI curves were as follows: IINS: 0.735, HR (95% CI) 0.037 [0.662-0.809], PLR: 0.724, HR (95% CI) 0.036 [0.655-0.794], PNI: 0.694, HR (95% CI) 0.038 [0.619-0.769]. In overall survival, the areas under the curves of IINS, PLR, and PNI were as follows: IINS: 0.738, HR (95% CI) 0.049 [0.642-0.834], PLR: 0.700, HR (95% CI) 0.039 [0.623-0.777], and PNI: 0.713 with HR (95% CI) 0.050 [0.615-0.811]. According to the findings, among patients with resectable breast cancer, preoperative IINS may be the most accurate indicator of both overall survival and progression-free survival. CONCLUSION: IINS may be a dependable marker for predicting postoperative survival in patients with breast cancer, and its prognostic value may be higher than that of traditional markers.