Effect of systemic immune-inflammation index on prognostic parameters and survival in patients with breast cancer under the age of 40 years

2021 ◽  
Vol 8 (1) ◽  
pp. 39-44
Author(s):  
Hacer Demir ◽  
İsmail Beypınar
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Roc Analysis ◽  
Treatment Plan ◽  
Clinical Stage ◽  
Logrank Test ◽  
Ki 67 ◽  
Significant Difference ◽  
Immune Inflammation ◽  
The Relationship

Objective: Systemic immune inflammation index, which is one of the systemic inflammatory markers obtained by using peripheral blood cells, neutrophils, lymphocyte and platelet counts, has been previously shown to be prognostic in many types of cancer, and it has been also shown in previous studies that SII was associated with prognosis in patients who received adjuvant and neoadjuvant therapy in breast cancer. In our study, the evaluation of the potential prognostic importance of SII in patients with breast cancer diagnosed before the age of 40 was aimed. Material and method: For the study, demographic, histopathological, clinical and file data of 129 patients who were diagnosed with breast cancer in the tertiary medical oncology outpatient clinic and were 40 years old and younger at the time of diagnosis were recorded retrospectively. SII was calculated according to the neutrophil count x platelet number/lymphocyte (NxP / L) formula, and those below the optimal cut-off value obtained by ROC analysis were classified as low SII, and those above it as High SII. The relationship between breast cancer clinicopathological variables and SII was evaluated by Chi-Square test. While the effect of SII on survival was evaluated by Kaplan Meiermethod, the Logrank test was used to evaluate survival in low and high groups. Results: For the study, 1400 patients diagnosed with breast cancer were reviewed and 129 patients who were under the age of 40 at the time of diagnosis were included. Patients who had insufficient follow-up or whose pre-treatment hemogram values could not be reached, who had medication use that could affect their hemogram parameters, and those with inflammatory diseases were not included. The median age in the study was 35, and the youngest patient was 21 years old. In the study group, based on the SII cut-off value of 720 calculated according to the roc analysis, 73 patients were in the low SII group and 56 patients were in the high SII group. When the relationship between prognostic factors of the patients and SII was examined, no statistically significant relationship was observed between age, hormone receptor status, Her-2 status, histological subtype, clinical stage, grade, Ki 67 status, lymph node involvement and SII. However, in the survival analysis, although the median value could not be reached between the two groups, there was a significant difference in overall survival with SII (p = 0.051) and it was observed that survival was worse in the high SII group, and the 3 and 5-year survival rates were worse in the high group compared to the low ones. Conclusion: In our study, we reached the conclusion that SII can be an independent prognostic factor for survival in patients with breast cancer diagnosed at 40 years of age or younger. Considering the SII status together with other prognostic factors in diagnosis, a more intensive treatment plan can be made for the patients. However, well-designed prospective studies including more patients are needed for the routine use of SII.

Neoadjuvant epirubicin, gemcitabine, and docetaxel for primary breast cancer: Survival and prognostic factors in two consecutive neoadjuvant phase I/II trials.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1096-1096
Author(s):  
Frederik Marme ◽  
Justo Lorenzo Bermejo ◽  
Hans-Peter Sinn ◽  
Peter Lichter ◽  
Florian Schuetz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Phase I ◽  
Survival Data ◽  
Primary Breast Cancer ◽  
Univariate Analysis ◽  
Pathologic Complete Response ◽  
Small Sample ◽  
Ki 67 ◽  
Significant Difference

1096 Background: We previously reported primary end points of two consecutive phase I/II trials which evaluated two different schedules of neoadjuvant gemcitabine (G), epirubicin (E) and docetaxel (Doc) for primary breast cancer. Here we report mature survival data and evaluate prognostic factors for disease-free (DFS) and overall survival (OS). Methods: 151 patients were treated in two phase I/II trials of G, E and Doc as neoadjuvant chemotherapy (NAC) for T2-4 N0-2 M0 PBC between Feb. ’02 and Dec. ’04. Patients were treated with six cycles of GEDoc (G 800mg/m2 day (d) 1+8, E 60-90mg/m2 d 1, Doc 60-75mg/m2 d 1 every three weeks) or five cycles of G 1250mg/m2 plus E 90-100mg/m2 every two weeks followed sequentially by four cycles of Doc 80-100mg/m2 every two weeks (GEsDoc). Pathologic complete response (pCR), clinical/pathological factors were correlated with DFS and OS. Results: There was no significant difference in DFS or OS between patients in the GEDoc and GEsDoc trial (DFS: Hazard ratio (HR) 1.13, p=0.67; OS: HR 1.06, p=0.88) with a 5-year DFS and OS of 72 vs 74% and 85 vs 86%, respectively. In an univariate analysis pCR unexpectedly was associated with a worse OS (HR 3.11; p= 0.007). HR for DFS showed a similar but non-significant trend (HR 1.78; p=0.1). Molecular subtypes (OS: HR [lum B] 3.17; [triple negative] 5.81; [HER2] 11.5; p=0.002), negative estrogen receptor (ER) status (OS: HR 3.14; p=0.002) and Ki-67 >20% (OS: HR 5.41; p=0.001) were all significantly associated with DFS and OS. The recently published CPS-EG score (Mittendorf 2011) was also significantly correlated with OS (p=0.006) and DFS (p=0.0006). In a multivariate analysis high Ki-67 was the only significant predictor of OS (HR 10.4; p=0.0026) whereas molecular subtype (p=0.05) and Ki-67 (p=0.04) were significantly associated with DFS. Conclusions: These results raise caution on the reliability of pCR as a single surrogate marker for survival in trials with small sample sizes. Our results emphazise the role of additional factors, esp. Ki-67 and subtypes. Integrative scores based on clinical and pathologic stage as well as tumor biology, might be more reliable predictors of survival.

Comparison of the effects of C-KIT, MMP-2, Ki-67, Bcl-2 and metallothionein expression on prognostic factors in skin and non-skin malignant melanomas

2021 ◽  
Author(s):  
Berna Eriten ◽  
Fahrettin Göze
Keyword(s):  
Prognostic Factors ◽  
Poor Prognosis ◽  
Cell Kinetics ◽  
Rare Event ◽  
Invasion And Metastasis ◽  
Ki 67 ◽  
Significant Difference ◽  
The Difference ◽  
High Level ◽  
The Relationship

Abstract Objectives: We aimed the relationship between with selected prognostic factors of MM, 1) C-KIT (CD117), which related to MM pathogenesis, 2) Ki-67, which is the determinant of cell kinetics, 3) MMP-2, which degradation of the basement membrane and extracellular matrix required for cell migration, invasion and metastasis in melanogenesis, 4) bcl-2, which reduces the apoptotic response to cytotoxic chemotherapy and 5) MT’s whose overexpression shows resistance to anticancer drugs and radiotherapy and thus poor prognosis.Material and Methods: In this study, 30 skin and 15 non-skin MMM cases diagnosed between January 01, 2000 and June 01, 2011 in SCU-TF Medical Pathology Department were examined. C-Kit, MMP-2, Ki-67, bcl-2 and MT markers were applied to these cases.Results: When comparing the skin and non-skin groups, the difference between Ki-67 and MMP-2 expressions was found to be statistically significant, but no significant difference was found in staining with c-Kit, MT and bcl-2. It was thought that high MMP-2, C-KIT, bcl-2 expressions and high Ki-67 index as well as loss of MT expression might be associated with poor prognosis. Despite the high level of KIT immunostaining in melanomas, this parameter does not appear to be a good predictor of the presence of molecular mutations. Mutations that activate KIT should be considered a rare event in this tumor.

Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Roc Analysis ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Test Specificity ◽  
The Relationship ◽  
Tumor Scintigraphy ◽  
Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

Prognostic subset of metastatic and non-metastatic luminal B breast cancer (LBBC) subtype based on Ki67 index.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12570-e12570
Author(s):  
Lalnun Puii ◽  
Lalram Sangi ◽  
Hrishi Varayathu ◽  
Samuel Luke Koramati ◽  
Beulah Elsa Thomas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Ki67 Index ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Her2 Positive ◽  
Ki 67 ◽  
Luminal B ◽  
Therapeutic Implications ◽  
Significant Difference

e12570 Background: Gene expression profiling for breast cancer has classified ER positive subtype into luminal A and luminal B. Luminal B breast cancer (LBBC) have a higher proliferation and poorer prognosis than luminal A tumors. Ki-67 index is the commonly used proliferation marker in breast cancer; however Ki67 expression can also be used to identify a subset of patients among LB with a favorable prognosis. This study attempts to verify this subset of LBBC patients based on DFS and PFS in non-metastatic and metastatic patients respectively. Methods: We retrospectively analyzed 80 IDC breast cancer patients diagnosed in 2013-2016 with complete follow-up till January-2021. We defined LBBC as ER+, PR+ or PR- , HER2+ or HER2- with a Ki67 index >20%. PFS was considered as the endpoint in patients presenting with metastatic disease whereas DFS was used in non-metastatic disease. The cut-off for ki67 was calculated using an X-tile plot (version 3.6.1, Yale University) by dividing Ki67 data into two populations: low and high, with randomized 1:1 “training” and “validation” cohorts. Results: Median age was 51.5 years. 18.7% (n=15) presented with metastasis at the time of diagnosis and their overall median PFS was found to be 25.8 months. The incidence of HER2 positive LBBC was found to be 15% (n=12) and none of them were found to be presented with metastasis. Survival and frequency of various sub groups in our study are enlisted in the given table. We estimated a Ki67 cut-off of 30% in patients with upfront metastatic disease and PFS was found to be higher in <30% compared to a Ki67 index >30% (38.9 months vs 19.7 months, p-0.002). Overall median DFS was not achieved in non-metastatic group (Mean DFS: 64.7 months) where as a statistically significant difference was observed in the survival of HER2 positive (median DFS: 53.5 months, mean DFS: 50.9) than HER2 negative patients (median DFS not achieved, mean: 66.97 months) ( p-0.021). We obtained a Ki67 cut-off of 32% in non- metastatic group and mean DFS was found to be higher in Ki67<32% (69 months) compared to Ki67>32% (61.4 months), however it failed to exhibit a statistically significant relationship ( p-0.373). Conclusions: Our study indicates that a subset of patients exists within metastatic and non-metastatic LBBC with differing prognosis based on Ki67. Larger studies are further required to confirm the findings and therapeutic implications.[Table: see text]

scholarly journals Breast Cancer Survival Defined by Biological Receptor and Menopausal Status in Vietnamese Women

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986527 ◽  
Author(s):  
Thang Vu Hong ◽  
Duc Nguyen Ba ◽  
Lambert Skoog ◽  
Van Ta Thanh ◽  
Edneia Tani
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Progesterone Receptor ◽  
Cox Model ◽  
Menopausal Status ◽  
Survival Rates ◽  
Factors Associated ◽  
Vietnamese Women ◽  
Significant Difference

Little is known about breast cancer in Vietnamese women. Previous studies have reported the frequencies of prognostic factors of breast cancer in this population. The aim of this study was to examine the prognostic factors associated with the survival rates of patients with breast cancer treated at the National Cancer Hospital, Hanoi, Vietnam. We recruited 248 women with operable breast cancer treated with surgery and adjuvant therapy. Tumor tissue samples were stained by many immunohistochemical approaches and analyzed for estrogen receptor, progesterone receptor, and HER2 gene amplification status. A Cox model was used to determine the relationship between survival and the prognostic factors. The disease-free survival rate, overall survival rate, and cancer-specific survival rate were 75.8%, 80.6%, and 86.4%, respectively, at 5 years and 62.3%, 68.1%, and 78.9%, respectively, at 10 years. The lung was the most common metastatic site. Women with factors associated with a poor prognosis (eg, advanced clinical stage, high tumor grade, progesterone receptor [PR] negativity, HER2 amplification) had significantly lower survival rates. Patients with PR-negative breast cancer had significantly worse survival rates compared to those who were PR positive, according to multivariate analysis (hazard ratio = 1.77, 95% confidence interval: 1.01-3.11, P = .045); however, there was only a statistically significant difference in postmenopausal patients. The PR was a prognostic factor in postmenopausal women with breast cancer, but not in premenopausal women.

scholarly journals Prominent Prognostic Factors in Aggressive Breast Cancer: A Review

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Kazem Nejati ◽  
Sedigheh Fekri Aval ◽  
Mohammadreza Alivand ◽  
Abolfazl Akbarzadeh ◽  
AmirAhmad Arabzadeh
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Growth Factor Receptor ◽  
Progression Free Survival ◽  
Lymph Node Status ◽  
Cancer Type ◽  
Ki 67 ◽  
Increased Risk ◽  
Aggressive Breast Cancer ◽  
Breast Cancer Type

Context: Breast cancer (BC) is the most common cancer in women worldwide. Hereditary susceptibility created by mutations in autosomal dominant genes is responsible for 5 to 10% of all BC cases in women. Recent studies have identified genes associated with increased risk for aggressive BC, providing the basis for better risk management. Evidence Acquisition: The latest information in National Center for Biotechnology Information (NCBI), Google Scholar, ScienceDirect, and Scopus were the main databases for finding articles. A combination of keywords of ‘metastasis’, ‘invasion’, ‘aggressive breast cancer’, ‘prognostic factor’, ‘mutation’, and ‘cancer treatment’ was searched in the databases to identify related articles. Titles and abstracts of the articles were studied to choose the right articles. Results: Mutations in breast cancer type 1 susceptibility protein (BRCA1) and breast cancer type 2 susceptibility protein (BRCA2) genes are two central players related to the high risk of BC. Mutation in tumor protein p53 (TP53) is another important mutation that leads to triple-negative BC. Although the majority of BC types are not associated with high-throughput mutant genes such as BRCA1, BRCA2, and TP53, they are associated with low-throughput genes, including DNA repair protein Rad50 (RAD50), Nijmegen breakage syndrome gene (NBS1), checkpoint kinase 2 (CHEK2), BRCA1-interacting protein 1 (BRIP1), E-cadherin gene (CDH1) and PALB2, UCHL1, aldehydedehydrogenase1A3 (ALDH1A3), androgen receptor (AR), 5-bisphosphate 3-kinase (PIK3CA), phosphatidylinositol-4, and luminal gene expression that are generally mutated in the global population. High tumor mutational burden (TMB) was associated with improved progression-free survival. Conclusions: The lymph node status, early tumor size, ER, PR, human epidermal growth factor receptor-2 (HER2), and Ki-67 are conventional prognostic factors for BC. However, these factors cannot exactly predict the aggressive behavior of BC. Hence, in this review, we discussed new prognostic factors of aggressive BCs that are useful for the treatment of patients with BC.

scholarly journals Systemic Immune-Inflammation Index Is Superior to Neutrophil to Lymphocyte Ratio in Prognostic Assessment of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Cong Jiang ◽  
Yubo Lu ◽  
Shiyuan Zhang ◽  
Yuanxi Huang
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Regression Models ◽  
Roc Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Breast Cancer Patients ◽  
Lymphocyte Ratio ◽  
Immune Inflammation ◽  
The Impact

Background and Methods. As a parameter integrating neutrophil (N), lymphocyte (L), and platelet (P) levels, altered systemic immune-inflammation index (SII) has been investigated in a number of malignant tumor types. Here, we explore the impact of SII in a cohort of 249 breast cancer patients receiving neoadjuvant chemotherapy (NAC), investigating the prognostic value of SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). All patients had complete follow-up data and pathological confirmation of breast cancer by a core needle biopsy prior to NAC treatment and surgery. All blood samples were obtained within one week prior to NAC. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off value for patient classification by SII, NLR, and PLR. Associations between clinicopathological variables by SII, NLR, and PLR were determined by a chi-squared test or Fisher’s exact test. Overall survival (OS) analysis was performed using Kaplan-Meier plots, log-rank tests, and Cox proportional hazards regression models. The Z test is used to compare the prognostic ability of SII, NLR, and PLR. Results. SII, NLR, and PLR did not define patient groups with distinct clinicopathological characteristics. SII, NLR, and PLR cut-off values were 547, 2.13, and 88.23, as determined by ROC analysis; the corresponding areas under the curve (AUCs) were 0.625, 0.555, and 0.571, respectively. Cox regression models identified SII as independently associated with OS. Patients with low SII had prolonged OS (65 vs. 41 months, P = 0.017 , HR: 3.24, 95% CI: 1.23-8.55). In the Z test, the difference in AUC between SII and NLR was statistically significant ( Z = 2.721 , 95% CI: 0.0194-0.119, P = 0.0065 ). Conclusion. Our study suggests that the pretreatment SII value is significantly correlated with OS in breast cancer patients undergoing NAC and that the prognostic utility of SII is superior to that of NLR and PLR.

Correlation between Changes in Prolactin and Melatonin Serum Levels after Radical Mastectomy

1987 ◽  
Vol 73 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Paolo Lissoni ◽  
Franco Paolorossi ◽  
Sandro Barni ◽  
Gabriele Tancini ◽  
Sergio Crispino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Stage ◽  
Radical Mastectomy ◽  
Serum Levels ◽  
Axillary Node ◽  
Neoplastic Disease ◽  
Before And After ◽  
Node Involvement ◽  
Breast Cancer Growth ◽  
The Relationship

Both prolactin (PRL) and melatonin (MLT) (the most important pineal hormone) have been shown to play a role in regulating breast cancer growth. The present study was carried out to investigate the relationship between PRL and MLT secretions in human breast cancer. Twenty-four women with breast cancer, at clinical stage T1-2 N0-2 M0, were evaluated before and after radical mastectomy. As controls, 14 women who underwent surgery for reasons other than neoplastic disease were included in the study. PRL and MLT serum levels were measured by RIA before and 15 days after surgery. There were no significant differences in mean PRL serum levels between patients and controls; mean MLT serum values were significantly higher in patients than in controls. In no control subject was PRL affected by surgery. In contrast, 13/24 breast cancer women showed high PRL levels after mastectomy; the PRL rise induced by surgery was significantly higher in patients without axillary node involvement. MLT was not affected by mastectomy in 13 patients, whereas it was enhanced in 5 women and decreased in the last 6 cases. No significant correlation was seen between PRL and MLT changes induced by mastectomy. The present study shows that radical mastectomy influences PRL and MLT secretions, however, its clinical significance remains to be established.

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