The relationship of MRI-DWI,NLR and LMR with efficacy of neoadjuvant chemotherapy for patients with breast can-cer and its diagnostic efficacy

ZHANG Ae; ZHANG Chao

doi:10.20258/j.cnki.1006-9011.2025.06.012

Abstract：Objective To analyze the neutrophil lymphocyte ratio(NLR)and lymphocyte monocyte ratio by magnetic reso-nance diffusion weighted imaging(MRI-DWI)and the relationship between LMR and neoadjuvant chemotherapy(NAC)for breast cancer and its diagnostic efficacy.Methods A total of 105 breast cancer patients who received NAC treatment were selected as the study subjects,and the patients with complete response(CR)and partial response(PR)were included in the effective group(41 cases)according to the solid tumor efficacy evaluation criteria of RECIST1.1.Patients with stable disease(SD)and progressive isease(PD)were included in the ineffective group(64 cases).Clinical data of patients were collected,and the expression of apparent diffusion coefficient(ADC),neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ra-tio(LMR)of patients in the effective and ineffective groups were compared.Pearson correlation coefficient was used to analyze the correlation between the expression of ADC,NLR and LMR and the efficacy of NAC.The area under receiver operating char-acteristic(ROC)curve was used to evaluate the diagnostic value of ADC,NLR and LMR alone and in combination in predicting NAC response in breast cancer patients.Results The expression levels of ADC and LMR in effective group were significantly higher than those in ineffective group,while,the expression levels of NLR were significantly lower than those in ineffective group(all P<0.05).Pearson correlation coefficient analysis showed that the expression of ADC,NLR and LMR in breast cancer patients was associated with ineffective NAC treatment(r=-0.494,0.507,-0.583,all P<0.05).ROC analysis results showed that before NAC treatment,when ADC,NLR and LMR were applied in breast cancer patients,the AUC values predicting NAC treatment ineffectiveness were 0.796,0.846 and 0.787,respectively.The AUC value of the combined prediction of ADC,NLR and LMR was 0.958,which was higher than that predicted by each index alone(Z=3.936,4.183,3.131,all P<0.05).Multivariate logistic regression analysis showed that the increase of NLR expression level was an independent risk fac-tor for ineffective NAC treatment in breast cancer patients,while,the decrease of ADC and LMR was a protective factor for inef-fective NAC treatment in breast cancer patients(P<0.05).Conclusion ADC,NLR and LMR in breast cancer are related to the efficacy of neoadjuvant chemotherapy.Abnormal increase of NLR and abnormal decrease of ADC and LMR in breast cancer pa-tients may indicate poor efficacy of neoadjuvant chemotherapy.Moreover,the combination of ADC,NLR and LMR predicts the efficacy of neoadjuvant chemotherapy with the largest area under the ROC curve,which can be used as a reference for evaluating the efficacy of neoadjuvant chemotherapy for breast cancer.