Pretreatment Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Stage Determination in Breast Cancer

BACKGROUND: Breast cancer tends to respond differently to treatments, which are usually determined by clinicopathological characteristics. Several studies evaluated the role of the peripheral blood test as diagnostic and prognostic markers in several types of solid cancer and neutrophil-to-lymphocyte ratio (NLR) and platelet-tolymphocyte ratio (PLR) are two of them which already tested. However, the evidence in breast cancer is still lacking. AIM: Therefore, the study aimed to investigate the value of NLR and PLR as biomarkers concerning breast cancer stage. METHODS: A retrospective study was conducted using breast cancer patients’ medical records from 2014 to 2019 at Sanglah General Hospital. The histopathological records and complete blood counts of the patients were collected and analyzed risk analysis model, receiver operator characteristics analysis, and correlation of NLR and PLR with cancer staging analysis used correlation test. RESULT: One hundred five patients data were used in this study, with 35 subjects had early-stage breast cancer while 70 subjects had an advanced stage. Breast cancer staging with NLR and PLR showed significant associations (p < 0.001). Both NLR and PLR had area under the curve >0.7 (p < 0.001). The cutoff, sensitivity, and specificity values of NLR and PLR were 2.504 (71%; 70%) and 157.1 (73%; 70%). Advanced stage of breast cancer was mostly found in high NLR and PLR value with (OR: 4.231; CI = 1.791-9.995, p < 0.001) and (OR: 3.949; 95% CI = 1.679–9.287; p < 0.001). CONCLUSION: From this preliminary study, pretreatment NLR and PLR values might determine the breast cancer stage. Further research is needed to evaluate the association between grade and patient survival.

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Patient Characteristics and Predictors of Advanced Breast Cancer Stage at a Public Referral Hospital in a Middle-Income Sub-Saharan African Country

Journal of Global Oncology ◽

10.1200/jgo.18.49800 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 33s-33s

Author(s):

B.M. Tau

Keyword(s):

Breast Cancer ◽

Advanced Cancer ◽

Clinical Characteristics ◽

Early Stage ◽

Cancer Stage ◽

Advanced Stage ◽

Breast Cancer Patients ◽

Middle Income ◽

Oncology Care ◽

Sub Saharan

Background: Breast cancer is the second leading cause of death in women in Botswana, a middle-income country in sub-Saharan Africa where cancer treatment is free to all citizens. While treatment is accessible, treatment outcomes may be limited by delayed diagnosis and or suboptimal treatment. Aim: As a preliminary step to understanding ways to improve early diagnosis of breast cancer in Botswana, we aimed to describe sociodemographic and clinical characteristics of breast cancer patients receiving specialized oncology care. Methods: Retrospective review of electronic data of patients enrolled in Thabatse Cancer Cohort study, including female patients diagnosed with breast cancer between October 2010 and July 2017 was conducted. Patient sociodemographic and clinical characteristics were described. We used univariate and multivariable logistic regression to explore predictors of advanced stage (III or IV) at presentation. Patients without known cancer stage were excluded. All factors significant in univariate analysis ( P < 0.05) were included in final multivariable model. Statistical analyses were performed using R on an EZR platform. Results: A total of 481 female breast cancer patients were included in our analysis, with median age of 52.4 (IQR 44.0- 64.4) years. Majority of patients were not married (61%), nearly half (48%) had primary school or less education, 54% had income of less than $50 per month, and 30% were HIV positive. Overall, 260 (54%) were diagnosed with advanced cancer stage, 144 (30%) had early-stage cancer, and 77 (16%) had unknown cancer stage. Compared with early-stage cancer; income of less than $50 per month (odds ratio [OR] 1.58, 95% CI 1.03-2.44) and not having an indoor toilet (OR 0.56, 95% CI 0.36-0.87) were significantly associated with advanced cancer. Importantly, no significant association was detected for HIV infection (OR 1.29, 95% CI 0.79-2.13), education (OR 1.19, 95% CI 0.77-1.83) and electricity at home (OR 0.97, 95% CI 0.56-1.64). In the adjusted model only income of less than $50 per month was significantly associated with advanced cancer (adjusted OR 1.85, 95% CI 1.17-2.93). Conclusion: Our findings indicate that a high proportion of breast cancer cases receiving specialized oncology care were diagnosed at an advanced stage. While patients from lower socioeconomic seem to be at higher risk, these data suggest that broad sectorial interventions are needed to reduce cancer stage at presentation rather than targeted programs focused on individual populations or barriers.

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High neutrophil to lymphocyte ratio and decreased CD69+NK cells represent a phenotype of high risk in early-stage breast cancer patients

OncoTargets and Therapy ◽

10.2147/ott.s160911 ◽

2018 ◽

Vol Volume 11 ◽

pp. 2901-2910 ◽

Cited By ~ 6

Author(s):

Pablo Mandó ◽

Manglio Rizzo ◽

María Paula Roberti ◽

Estefanía Juliá ◽

María Betina Pampena ◽

...

Keyword(s):

Breast Cancer ◽

High Risk ◽

Nk Cells ◽

Cancer Patients ◽

Early Stage ◽

Neutrophil To Lymphocyte Ratio ◽

Early Stage Breast Cancer ◽

Breast Cancer Patients ◽

Lymphocyte Ratio

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Association of the neutrophil-to-lymphocyte ratio with brain metastases in Hispanic breast cancer patients.

Cancer Treatment and Research Communications ◽

10.1016/j.ctarc.2021.100452 ◽

2021 ◽

Vol 29 ◽

pp. 100452

Author(s):

Bernardo Cacho-Díaz ◽

Mariana Daniela Cortes-Ortega ◽

Nancy Reynoso-Noverón ◽

Talia Wegman-Ostrosky ◽

Cristian Arriaga-Canon ◽

...

Keyword(s):

Breast Cancer ◽

Brain Metastases ◽

Cancer Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Breast Cancer Patients ◽

Lymphocyte Ratio

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The elevated preoperative derived neutrophil-to-lymphocyte ratio predicts poor clinical outcome in breast cancer patients

Tumor Biology ◽

10.1007/s13277-015-3805-4 ◽

2015 ◽

Vol 37 (1) ◽

pp. 361-368 ◽

Cited By ~ 19

Author(s):

Sabine Krenn-Pilko ◽

Uwe Langsenlehner ◽

Tatjana Stojakovic ◽

Martin Pichler ◽

Armin Gerger ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Outcome ◽

Cancer Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Breast Cancer Patients ◽

Poor Clinical Outcome ◽

Lymphocyte Ratio

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

BioMed Research International ◽

10.1155/2020/7961568 ◽

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.

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