AbstractThe aim of the present study was to evaluate the correlations of peripheral blood cell count (PBC)-derived ratios with neopterin concentration and biomarkers of atherosclerosis risk in patients with history of breast cancer. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were calculated in three cohorts of patients with a history of breast cancer and in controls. Significant differences were observed between PBC-derived ratios obtained from automated and manual counts. NLR and PLR were significantly higher and LMR was significantly lower in patients. NLR and PLR correlated positively with each other and negatively with LMR. NLR exhibited a significant correlation with age, glucose and C-reactive protein (CRP) concentrations, whereas LMR correlated negatively with CRP. With the exception of a correlation between LMR and urinary or serum neopterin concentrations in controls, no other correlation between neopterin concentrations and PBC-derived ratios was observed. NLR ≥3 was a significant predictor of poor survival, but neither urinary neopterin ≥205 μmol/mol creatinine, NLR ≥150 nor LMR ≥4.25 was significantly associated with survival. In conclusion, no consistent correlation was observed between urinary and serum neopterin concentrations and any of the PBC-derived ratios. In a cohort of breast cancer patients, a higher NLR predicted poor survival.

The aim of the present study was to examine the changes in intima-media thickness (IMT) and myocardial perfusion in association with other laboratory risk factors for atherosclerosis in patients treated with therapy that targeted vascular endothelial growth factor (VEGF). IMT, myocardial perfusion and laboratory risk factors of atherosclerosis were studied in 58 patients with metastatic colorectal carcinoma or metastatic renal cell carcinoma prior to and at 3-monthly intervals during anti-VEGF treatment. Compared with the pretreatment IMT, the results indicated that the IMT was consistently increased during therapy in the two patient groups. Patient blood pressure and concentration of troponin T increased transiently. An increase in the concentration of high-density lipoprotein cholesterol and decrease in the concentrations of C-reactive protein and homocysteine were also observed. Novel myocardial ischemia was evident in individual patients. In conclusion, anti-VEGF therapy affects the laboratory risk factors of atherosclerosis and results in an acceleration of atherosclerosis, as demonstrated by increased IMT.

AbstractThe immune response crucially determines the survival of patients with malignant tumors including breast carcinoma. The aim of the present study was to evaluate retrospectively an association of peripheral blood cell count (PBC)-derived ratios and urinary neopterin concentration with prognosis in breast cancer patients. Urinary neopterin, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were retrospectively analyzed in a cohort of 474 breast cancer patients. NLR and PLR correlated positively with each other and negatively with LMR, but no correlation between neopterin concentrations and PBC-derived ratios was observed. Increased urinary neopterin concentration was a significant predictor of poor survival in patients with active disease, but PLR, NLR or LMR were not significantly associated with survival in multivariate analysis. In conclusion, increased urinary neopterin was a significant predictor of poor survival in patients with breast cancer and active disease.

The aim of the present study was to evaluate the prevalence of the risk factor of atherosclerosis in patients with history of breast cancer. C-reactive protein, lipoprotein (a), cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, homocysteine, fibrinogen, glucose, magnesium, uric acid, and urinary albumin were determined by routine methods in 61 patients with history of breast cancer and 74 control subjects. Urinary neopterin and creatinine concentrations were measured by high-performance liquid chromatography, and intima-media thickness was determined sonographically. Breast cancer patients were significantly older and also had higher systolic blood pressure, glycosylated hemoglobin, lipoprotein (a), serum neopterin, and intima-media thickness. Serum HDL cholesterol and magnesium concentrations were significantly higher in controls compared with patients. Differential patterns of associations between the risk factors of atherosclerosis were observed in patients with history of breast cancer compared with controls. In conclusion, the prevalence of risk factors of atherosclerosis is high in patients with history of breast cancer. Differential associations between risk factors suggest possible differences in the pathogenesis of atherosclerosis in breast cancer patients and controls.

The aim of the present study was to evaluate the association between changes in peripheral blood cell count and neopterin concentrations in patients with a history of breast cancer. Peripheral blood cell count, serum ferritin, serum neopterin and urinary neopterin concentrations were determined in 61 patients with a history of breast cancer and 74 control subjects. Hemoglobin, relative lymphocyte count and absolute lymphocyte count were lower, and relative neutrophil count, ferritin and serum neopterin concentrations were significantly higher in breast cancer patients than in controls. Compared to controls, the difference in hemoglobin concentration was statistically significant only in patients with active disease. Significant negative correlations were observed between urinary neopterin and hemoglobin as well as between serum neopterin and relative lymphocyte counts in breast cancer patients. Increased ferritin concentrations were associated with a history of hypertension, but higher absolute lymphocyte counts were associated with hypertension only in subjects without history of cancer. In conclusion, in patients with a history of breast cancer, anemia is associated with disease activity and systemic immune activation. Ferritin concentrations are increased in subjects with hypertension.