Abstract: Objective This study analyzed the relationship between the sentinel lymph node(SLN) 1-2 positive early invasive breast cancer non-sentinel lymph node(NSLN) status and preoperative neutrophil-to-lymphocyte ratio(NLR).
Method A retrospective analysis of the clinicopathological indicators and preoperative blood routine data of patients with positive SLN1-2 positive and further axillary dissection for early invasive breast cancer who were admitted to the Affiliated Cancer Hospital of Zhengzhou University from October 1,2015 to December 1,2019.The NLR application value was evaluated by the receiver working curve and the area under the curve.Univariate and multivariate analysis was used to analyze the clinicopathological indicators and the relationship between preoperative NLR and NSLN status.
Result A total of 213 cases met the inclusion criteria.The best cut-off value of NLR is 1.8,the area under the curve is 0.718,the sensitivity is 68.7%,and the specificity is 73.1%.Univariate analysis found Her-2 status,SLN positive ratio and NLR and NSLN status(P<0.05),multivariate analysis showed SLN positive ratio(SLN positive ratio R=1,0.5≤R<1 compared with SLN positive ratio R<0.05 OR were 6.756 and 1.891,respectively,with NLR(OR:6.154,95% CI:3.130-12.100,P<0.001) were independent predictors of NSLN.
Conclusion Preoperative NLR is an effective predictor of NSLN status,but further research is needed to confirm its clinical value.

Key words: early breast cancer, non-sentinel lymph node, neutrophil to lymphocyte rate