Breast cancer prognostication with neutrophil–lymphocyte ratio and platelet–lymphocyte ratio

Abstract

Introduction Peripheral blood-derived inflammation-based markers such as neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) have been recently evaluated as prognostic markers in solid tumors. Although evidence to support these markers as prognostic factors is documented in gastrointestinal cancers, little is known of their impact on breast cancer (BC). Patients and methods A total of 100 patients presented with resectable early-stage BC treated with neoadjuvant chemotherapy. Tumor characteristics included tumor size, number of positive lymph nodes, estrogen and progesterone receptors, tumor grade, lympho-vascular invasion, and human epidermal growth factor receptor 2 (HER2) status. Sample of peripheral blood was analyzed and NLR and PLR were calculated. Results Forty-two (42%) patients were judged as having low NLR and 58 (58%) as high NLR. Low NLR was significantly correlated with younger age (P=0.028), premenopausal status (P=0.032), pathological complete response result (P<0.001), and triple-negative BC phenotype (P<0.001). The low-PLR group had significantly more patients older than 52 years old (P=0.001) and postmenopausal patients (P=0.001) than the high-PLR group. The low-PLR group also had a higher pathological complete response rate (P=0.024). The low-PLR group was found to have significantly longer Defensive Functioning Scale (P=0.001) than the high-PLR group. Univariate analysis showed that lymph node metastasis (P=0.040) and a high PLR (P=0.010) were unfavorable prognostic factors. Moreover, multivariate analysis also revealed that lymph node metastasis (P=0.030) and a high PLR (P=0.010) were independent, unfavorable prognostic factors in BC. Conclusion Both NLR and PLR are independently associated with an increased risk of Defensive Functioning Scale in BC.

Keywords

• breast cancer
• neutrophil–lymphocyte ratio
• platelet–lymphocyte ratio