An Analysis of Preoperative Inflammatory Indicators That Influence the Drainage Tube Retention Time in Patients with Breast Cancer Surgery

Figures & data

Table 1 Clinicopathological Features of Patients with Breast Cancer in the Present Study

n	Level	Overall	DTRT<13 (d)	DTRT ≥13 (d)	p
		N=121	N=67	N=54
Age (median [IQR])		46.00 [38.00, 56.00]	46.00 [38.00, 57.00]	45.00 [38.25, 55.00]	0.624
Weight (median [IQR])		60.00 [54.00, 66.00]	59.00 [52.00, 65.00]	60.50 [55.00, 66.00]	0.383
Height (median [IQR])		1.61 [1.58, 1.65]	1.61 [1.58, 1.65]	1.62 [1.58, 1.65]	0.738
BMI (median [IQR])		22.83 [20.58, 25.78]	21.99 [20.56, 25.86]	23.21 [21.02, 25.75]	0.274
Healthy lower arm circumference (median [IQR])		19.00 [17.50, 24.00]	19.00 [18.00, 23.50]	19.50 [17.50, 23.88]	0.863
Healthy upper arm circumference (median [IQR])		26.00 [24.00, 28.00]	26.00 [24.00, 28.00]	26.50 [24.00, 28.00]	0.586
Affected side lower arm circumference (median [IQR])		19.00 [18.00, 23.50]	19.00 [18.00, 23.25]	19.00 [17.62, 23.38]	0.712
Affected side upper arm circumference (median [IQR])		26.00 [24.00, 28.00]	26.00 [24.00, 28.00]	26.25 [24.00, 28.00]	0.615
Chest wall drainage tube (median [IQR])		13.00 [10.00, 18.00]	10.00 [6.00, 12.00]	18.00 [15.25, 21.00]	<0.001
Axillary drainage tube (median [IQR])		13.00 [10.00, 17.00]	12.00 [9.00, 13.00]	16.00 [13.25, 20.00]	<0.001
Marital status (%)	Married	107 (88.4)	60 (89.6)	47 (87.0)	0.592
	Unmarried	8 (6.6)	5 (7.5)	3 (5.6)
	Divorce	5 (4.1)	2 (3.0)	3 (5.6)
	Widowed	1 (0.8)	0 (0.0)	1 (1.9)
Occupation (%)	Mental worker	101 (83.5)	57 (85.1)	44 (81.5)	0.511
	Manual worker	1 (0.8)	0 (0.0)	1 (1.9)
	Others	19 (15.7)	10 (14.9)	9 (16.7)
Type of surgery (%)	MRM	31 (25.6)	13 (19.4)	18 (33.3)	0.006
	M+SLNB	33 (27.3)	23 (34.3)	10 (18.5)
	BCS+SLNB	15 (12.4)	13 (19.4)	2 (3.7)
	BCS+ALND	7 (5.8)	4 (6.0)	3 (5.6)
	BR	35 (28.9)	14 (20.9)	21 (38.9)
Tumor size (%)	≤2cm	54 (44.6)	34 (50.7)	20 (37.0)	0.306
	>2 and <5cm	58 (47.9)	29 (43.3)	29 (53.7)
	≥5cm	9 (7.4)	4 (6.0)	5 (9.3)
TLN (median [IQR])		7.00 [4.00, 19.00]	6.00 [3.00, 17.00]	8.00 [5.00, 22.75]	0.049
PLN (median [IQR])		0.00 [0.00, 1.00]	0.00 [0.00, 1.00]	0.00 [0.00, 1.75]	0.683
Histologic type (%)	Noninvasive carcinoma	18 (14.9)	12 (17.9)	6 (11.1)	0.479
	Invasive special carcinoma	5 (4.1)	2 (3.0)	3 (5.6)
	Invasive nonspecific carcinoma	98 (81.0)	53 (79.1)	45 (83.3)
Histologic grade (%)	0	6 (5.0)	3 (4.5)	3 (5.6)	0.628
	I	35 (28.9)	22 (32.8)	13 (24.1)
	II	62 (51.2)	34 (50.7)	28 (51.9)
	III	18 (14.9)	8 (11.9)	10 (18.5)
Pathological T stage (%)	Tis/T0	28 (23.1)	16 (23.9)	12 (22.2)	0.050
	T1	56 (46.3)	37 (55.2)	19 (35.2)
	T2	36 (29.8)	14 (20.9)	22 (40.7)
	T3	1 (0.8)	0 (0.0)	1 (1.9)
Pathological N stage (%)	N0	82 (67.8)	47 (70.1)	35 (64.8)	0.891
	N1	22 (18.2)	12 (17.9)	10 (18.5)
	N2	13 (10.7)	6 (9.0)	7 (13.0)
	N3	4 (3.3)	2 (3.0)	2 (3.7)
Pathological TNM stage (%)	Tis/T0	27 (22.3)	16 (23.9)	11 (20.4)	0.746
	I	40 (33.1)	24 (35.8)	16 (29.6)
	II	37 (30.6)	19 (28.4)	18 (33.3)
	III	17 (14.0)	8 (11.9)	9 (16.7)
Molecular subtype (%)	Luminal A	38 (31.4)	25 (37.3)	13 (24.1)	0.416
	Luminal B HER2+	56 (46.3)	30 (44.8)	26 (48.1)
	Luminal B HER2-	18 (14.9)	9 (13.4)	9 (16.7)
	HER2 enriched	4 (3.3)	1 (1.5)	3 (5.6)
	Triple negative	5 (4.1)	2 (3.0)	3 (5.6)
ER status (%)	Negative	28 (23.1)	16 (23.9)	12 (22.2)	1.000
	Positive	93 (76.9)	51 (76.1)	42 (77.8)
PR status (%)	Negative	24 (19.8)	14 (20.9)	10 (18.5)	0.923
	Positive	97 (80.2)	53 (79.1)	44 (81.5)
HER2 (%)	Negative	99 (81.8)	57 (85.1)	42 (77.8)	0.425
	Positive	22 (18.2)	10 (14.9)	12 (22.2)
Ki-67 (%)	Negative	41 (33.9)	27 (40.3)	14 (25.9)	0.142
	Positive	80 (66.1)	40 (59.7)	40 (74.1)
AR (%)	Negative	29 (24.0)	20 (29.9)	9 (16.7)	0.140
	Positive	92 (76.0)	47 (70.1)	45 (83.3)
CK5/6 (%)	Negative	114 (94.2)	62 (92.5)	52 (96.3)	0.625
	Positive	7 (5.8)	5 (7.5)	2 (3.7)
E-cad (%)	Negative	35 (28.9)	22 (32.8)	13 (24.1)	0.393
	Positive	86 (71.1)	45 (67.2)	41 (75.9)
EGFR (%)	Negative	104 (86.0)	56 (83.6)	48 (88.9)	0.567
	Positive	17 (14.0)	11 (16.4)	6 (11.1)
P53 (%)	Negative	50 (41.3)	30 (44.8)	20 (37.0)	0.500
	Positive	71 (58.7)	37 (55.2)	34 (63.0)
TOP2A (%)	Negative	53 (43.8)	35 (52.2)	18 (33.3)	0.058
	Positive	68 (56.2)	32 (47.8)	36 (66.7)
Lymph vessel invasion (%)	Negative	99 (81.8)	55 (82.1)	44 (81.5)	1.000
	Positive	22 (18.2)	12 (17.9)	10 (18.5)
Neural invasion (%)	Negative	104 (86.0)	57 (85.1)	47 (87.0)	0.964
	Positive	17 (14.0)	10 (14.9)	7 (13.0)

Abbreviations: BMI, body mass index; TLN, Total lymph nodes; PLN, Positive lymph nodes; ER, estrogen receptor; PR, progesterone receptor; HER2, Human Epidermal Growth Factor Receptor 2; AR, androgen receptor; CK5/6, Cytokeratin 5/6; E-cad, E-cadherin; EGFR, Epidermal Growth Factor Receptor; TOP2A, topoisomerase 2A.

Table 2 Comparison of Preoperative Inflammatory Parameters with the Drainage Tube Retention Time

n	Level	Overall	DTRT<13 (d)	DTRT ≥13 (d)	p
		N=121	N=67	N=54
LDH (median [IQR])		158.10 [141.10, 180.00]	158.10 [141.05, 178.00]	158.55 [141.85, 181.88]	0.741
ALB (median [IQR])		44.40 [42.80, 46.60]	43.90 [42.80, 46.35]	45.30 [42.85, 46.98]	0.370
CRP (median [IQR])		0.02 [0.00, 0.08]	0.03 [0.00, 0.08]	0.02 [0.00, 0.08]	0.688
CHOL (median [IQR])		4.83 [4.25, 5.53]	4.80 [4.24, 5.68]	4.86 [4.30, 5.46]	0.942
FIB (median [IQR])		2.73 [2.46, 3.08]	2.77 [2.48, 3.04]	2.65 [2.28, 3.10]	0.289
W (median [IQR])		5.68 [5.02, 6.94]	5.64 [5.03, 6.50]	5.84 [5.02, 7.08]	0.406
R (median [IQR])		4.45 [4.21, 4.69]	4.54 [4.28, 4.70]	4.39 [4.08, 4.69]	0.194
Hb (median [IQR])		133.00 [128.00, 140.00]	135.00 [129.50, 140.00]	132.00 [122.25, 139.00]	0.057
N (median [IQR])		3.56 [2.87, 4.46]	3.56 [2.89, 4.37]	3.57 [2.84, 4.78]	0.778
L (median [IQR])		1.69 [1.37, 2.15]	1.69 [1.38, 2.15]	1.70 [1.36, 2.14]	0.956
M (median [IQR])		0.30 [0.24, 0.36]	0.29 [0.24, 0.36]	0.30 [0.25, 0.36]	0.444
P (median [IQR])		252.00 [208.00, 283.00]	245.00 [209.00, 284.00]	255.50 [208.00, 282.75]	0.802
NLR (%)	<1.86	44 (36.4)	22 (32.8)	22 (40.7)	0.479
	≥1.86	77 (63.6)	45 (67.2)	32 (59.3)
dNLR (%)	<1.48	45 (37.2)	22 (32.8)	23 (42.6)	0.360
	≥1.48	76 (62.8)	45 (67.2)	31 (57.4)
MLR (%)	<0.12	24 (19.8)	14 (20.9)	10 (18.5)	0.923
	≥0.12	97 (80.2)	53 (79.1)	44 (81.5)
PLR (%)	<159.3	77 (63.6)	40 (59.7)	37 (68.5)	0.417
	≥159.3	44 (36.4)	27 (40.3)	17 (31.5)
SIRI (%)	<0.63	62 (51.2)	38 (56.7)	24 (44.4)	0.246
	≥0.63	59 (48.8)	29 (43.3)	30 (55.6)
SII (%)	<262.5	14 (11.6)	5 (7.5)	9 (16.7)	0.198
	≥262.5	107 (88.4)	62 (92.5)	45 (83.3)
PNI (%)	<55.58	88 (72.7)	53 (79.1)	35 (64.8)	0.121
	≥55.58	33 (27.3)	14 (20.9)	19 (35.2)
NRI (%)	<109.7	44 (36.4)	31 (46.3)	13 (24.1)	0.020
	≥109.7	77 (63.6)	36 (53.7)	41 (75.9)
AFR (%)	<17.36	78 (64.5)	48 (71.6)	30 (55.6)	0.100
	≥17.36	43 (35.5)	19 (28.4)	24 (44.4)
HALP (%)	<34.87	44 (36.4)	27 (40.3)	17 (31.5)	0.417
	≥34.87	77 (63.6)	40 (59.7)	37 (68.5)
CONUT (%)	<1	69 (57.0)	40 (59.7)	29 (53.7)	0.633
	≥1	52 (43.0)	27 (40.3)	25 (46.3)
BIPI (%)	Good	108 (89.3)	61 (91.0)	47 (87.0)	0.412
	Intermediate	12 (9.9)	5 (7.5)	7 (13.0)
	Poor	1 (0.8)	1 (1.5)	0 (0.0)

Abbreviations: LDH, lactic dehydrogenase; ALB, albumin; CRP, C-reactive protein; CHOL, cholesterol; FIB, fibrinogen; W, white blood cell; R, red blood cell; Hb, hemoglobin; N, neutrophils; L, lymphocyte; M, monocyte; P, platelet; NLR, neutrophil-to-lymphocyte ratio; dNLR, derived neutrophil-to-lymphocyte ratio; MLR, monocyte-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; SII, systemic immune-inflammation index; PNI, prognostic nutritional index; NRI, nutritional risk index; AFR, albumin-to-fibrinogen ratio; HALP, hemoglobin × albumin × lymphocyte / platelet; CONUT, controlling nutritional status; BIPI, breast immune prognostic index.

Table 3 Univariate and Multivariate Logistic Regression Analysis of Factors Affecting Drainage Tube Retention Time in Patients with Breast Cancer

n	Level	Univariate				Multivariate
		OR	95% CI low	95% CI high	p	OR	95% CI low	95% CI high	p
Age	<46	1(Reference)			0.935
	≥46	0.971	0.473	1.991
Marital status	Married	1(Reference)			0.668
	Unmarried + Divorce + Widowed	1.277	0.410	3.974
Occupation	Mental worker	1(Reference)			0.597
	Manual worker + Others	1.295	0.491	3.425
Weight	<60	1(Reference)			0.372
	≥60	1.389	0.677	2.875
Height	<1.61	1(Reference)			0.837
	≥1.61	0.927	0.451	1.905
BMI	<22.83	1(Reference)			0.082
	≥22.83	1.906	0.926	3.980
LDH	<158.10	1(Reference)			0.935
	≥158.10	0.971	0.473	1.991
ALB	<44.40	1(Reference)			0.168
	≥44.40	1.662	0.810	3.453
CRP	<0.02	1(Reference)			0.627
	≥0.02	0.837	0.406	1.715
CHOL	<4.83	1(Reference)			0.776
	≥4.83	1.110	0.541	2.280
FIB	<2.73	1(Reference)			0.329
	≥2.73	0.699	0.338	1.433
W	<5.68	1(Reference)			0.516
	≥5.68	1.269	0.619	2.614
R	<4.45	1(Reference)			0.181
	≥4.45	0.611	0.294	1.253
Hb	<133	1(Reference)			0.036	1(Reference)			0.035
	≥133	0.457	0.217	0.943		0.401	0.168	0.926
N	<3.56	1(Reference)			0.966
	≥3.56	0.985	0.480	2.022
L	<1.69	1(Reference)			0.904
	≥1.69	1.045	0.510	2.147
M	<0.30	1(Reference)			0.144
	≥0.30	1.719	0.834	3.591
P	<252	1(Reference)			0.776
	≥252	1.110	0.541	2.280
Type of surgery	Mastectomy	1(Reference)			0.019	1(Reference)			0.040
	Breast-conserving surgery	0.278	0.086	0.759		0.273	0.071	0.883
Tumor size	<2	1(Reference)			0.133
	≥2	1.752	0.848	3.676
Histologic type	Ductal	1(Reference)			0.556
	Lobular + Others	1.321	0.529	3.441
Histologic grade	0+I	1(Reference)			0.376
	II+III	1.414	0.661	3.079
Pathological T stage	Tis/T0	1(Reference)			0.011	1(Reference)			0.039
	T1+T2+T3	2.809	1.278	6.363		6.684	1.155	44.961
Pathological N stage	1	1(Reference)			0.533
	2	1.276	0.592	2.752
Pathological TNM stage	1	1(Reference)			0.287
	2	1.481	0.720	3.070
TLN	<7	1(Reference)			0.394
	≥7	1.367	0.667	2.824
PLN	<1	1(Reference)			0.816
	≥1	1.095	0.506	2.358
Molecular subtype	Luminal A + Luminal B (HER2+) + Luminal B (HER2-)	1(Reference)			0.181
	HER2 enriched + Triple negative	2.667	0.668	13.140
ER status	Negative	1(Reference)			0.830
	Positive	1.098	0.470	2.618
PR status	Negative	1(Reference)			0.745
	Positive	1.162	0.473	2.939
HER2	Negative	1(Reference)			0.304
	Positive	1.629	0.643	4.203
Ki-67	Negative	1(Reference)			0.099
	Positive	1.929	0.894	4.290
AR	Negative	1(Reference)			0.095
	Positive	2.128	0.897	5.372
CK5/6	Negative	1(Reference)			0.388
	Positive	0.477	0.066	2.313
E-cad	Negative	1(Reference)			0.292
	Positive	1.542	0.696	3.518
EGFR	Negative	1(Reference)			0.406
	Positive	0.636	0.206	1.803
P53	Negative	1(Reference)			0.391
	Positive	1.378	0.665	2.892
TOP2A	Negative	1(Reference)			0.039	1(Reference)			0.226
	Positive	2.188	1.051	4.656		1.945	0.672	5.920
Lymph vessel invasion	Negative	1(Reference)			0.931
	Positive	1.042	0.404	2.638
Neural invasion	Negative	1(Reference)			0.758
	Positive	0.849	0.288	2.382
Healthy lower arm circumference	<19	1(Reference)			0.655
	≥19	1.178	0.575	2.423
Healthy upper arm circumference	<26	1(Reference)			0.329
	≥26	1.431	0.698	2.955
Affected side lower arm circumference	<19	1(Reference)			0.966
	≥19	1.016	0.495	2.085
Affected side upper arm circumference	<26	1(Reference)			0.368
	≥26	1.393	0.678	2.879
Chest wall drainage tube	<13	1(Reference)			0.000	1(Reference)			0.000
	≥13	92.188	29.083	374.069		127.427	25.938	1139.723
Axillary drainage tube	<13	1(Reference)			0.000	1(Reference)			0.480
	≥13	5.298	2.441	12.090		1.872	0.311	11.822
NLR	<1.86	1(Reference)			0.370
	≥1.86	0.711	0.336	1.498
dNLR	<1.48	1(Reference)			0.271
	≥1.48	0.659	0.312	1.383
MLR	<0.12	1(Reference)			0.745
	≥0.12	1.162	0.473	2.939
PLR	<159.3	1(Reference)			0.317
	≥159.3	0.681	0.317	1.438
SIRI	<0.63	1(Reference)			0.181
	≥0.63	1.638	0.798	3.398
SII	<262.5	1(Reference)			0.124
	≥262.5	0.403	0.117	1.248
PNI	<55.58	1(Reference)			0.082
	≥55.58	2.055	0.918	4.698
NRI	<109.7	1(Reference)			0.013	1(Reference)			0.025
	≥109.7	2.716	1.256	6.116		2.837	1.164	7.292
AFR	<17.36	1(Reference)			0.068
	≥17.36	2.021	0.954	4.345
HALP	<34.87	1(Reference)			0.317
	≥34.87	1.469	0.695	3.159
CONUT	<1	1(Reference)			0.508
	≥1	1.277	0.619	2.645
BIPI	Good	1(Reference)			0.481
	Intermediate + Poor	1.514	0.473	4.990

Abbreviations: BMI, body mass index; LDH, lactic dehydrogenase; ALB, albumin; CRP, C-reactive protein; CHOL, cholesterol; FIB, fibrinogen; W, white blood cell; R, red blood cell; Hb, hemoglobin; N, neutrophils; L, lymphocyte; M, monocyte; P, platelet; TLN, Total lymph nodes; PLN, Positive lymph nodes; ER, estrogen receptor; PR, progesterone receptor; HER2, Human Epidermal Growth Factor Receptor 2; AR, androgen receptor; CK5/6, Cytokeratin 5/6; E-cad, E-cadherin; EGFR, Epidermal Growth Factor Receptor; TOP2A, topoisomerase 2A; NLR, neutrophil-to-lymphocyte ratio; dNLR, derived neutrophil-to-lymphocyte ratio; MLR, monocyte-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; SII, systemic immune-inflammation index; PNI, prognostic nutritional index; NRI, nutritional risk index; AFR, albumin-to-fibrinogen ratio; HALP, hemoglobin × albumin × lymphocyte / platelet; CONUT, controlling nutritional status; BIPI, breast immune prognostic index.

Figure 1 Nomogram constructed by the multivariate Logistic regression analysis. ***Statistical significance of P value.

Table 4 The Useful Factors by Univariate Logistic Regression Analysis for Drainage Tube at Different Times

n	Level	Overall	DTRT≤7 (d)	DTRT≤14 (d)	DTRT≤21 (d)	DTRT>21 (d)	p
		121	24	48	38	11
Hb (%)	<133	61 (50.4)	10 (41.7)	21 (43.8)	23 (60.5)	7 (63.6)	0.271
	≥133	60 (49.6)	14 (58.3)	27 (56.2)	15 (39.5)	4 (36.4)
Type of surgery (%)	Mastectomy	98 (81.0)	10 (41.7)	44 (91.7)	34 (89.5)	10 (90.9)	<0.001
	Breast-conserving surgery	23 (19.0)	14 (58.3)	4 (8.3)	4 (10.5)	1 (9.1)
Pathological T stage (%)	Tis/T0	84 (69.4)	20 (83.3)	37 (77.1)	21 (55.3)	6 (54.5)	0.041
	T1+T2+T3	37 (30.6)	4 (16.7)	11 (22.9)	17 (44.7)	5 (45.5)
TOP2A (%)	Negative	53 (43.8)	13 (54.2)	23 (47.9)	14 (36.8)	3 (27.3)	0.341
	Positive	68 (56.2)	11 (45.8)	25 (52.1)	24 (63.2)	8 (72.7)
Chest wall drainage tube (%)	<13	63 (52.1)	18 (75.0)	41 (85.4)	4 (10.5)	0 (0.0)	<0.001
	≥13	58 (47.9)	6 (25.0)	7 (14.6)	34 (89.5)	11 (100.0)
Axillary drainage tube (%)	<13	70 (57.9)	12 (50.0)	31 (64.6)	20 (52.6)	7 (63.6)	0.557
	≥13	51 (42.1)	12 (50.0)	17 (35.4)	18 (47.4)	4 (36.4)
NRI (%)	<109.7	44 (36.4)	13 (54.2)	19 (39.6)	11 (28.9)	1 (9.1)	0.047
	≥109.7	77 (63.6)	11 (45.8)	29 (60.4)	27 (71.1)	10 (90.9)

Abbreviations: Hb, hemoglobin; TOP2A, topoisomerase 2A; NRI, nutritional risk index.