413 Prognostic value of the tumor infiltrating lymphocytes and the neutrophil-to-lymphocyte ratio in patients with advanced ovarian cancer

Álvarez-Abril, Beatriz; García, Esmeralda Balaguer; Morena, Pilar de la; Ivars, Alejandra; Sanchez, Manuel Villa; Chaves, A.; Pastor, Francisco; Marín, Gema; Ayala, Francisco J.; Martínez, Elena García

doi:10.1136/ijgc-2020-esgo.132

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“…Evidence regarding the relationship between NLR and TILs is less established. Cohorts analysing NLR and TILs in colorectal and ovarian cancer patients did not find correlations between NLR and TILs, 4,5,8 whereas a negative correlation was demonstrated for biliary tract cancers 27 . Regardless, all those studies showed high‐NLR and low‐TILs to be associated with a worse prognosis 4,5,8,27 .…”

Section: Discussionmentioning

confidence: 95%

“…Cohorts analysing NLR and TILs in colorectal and ovarian cancer patients did not find correlations between NLR and TILs, 4,5,8 whereas a negative correlation was demonstrated for biliary tract cancers 27 . Regardless, all those studies showed high‐NLR and low‐TILs to be associated with a worse prognosis 4,5,8,27 . For breast cancer, most studies regarding the relationship of NLR and TILs included only pretreatment NLR 6,7,28,29 .…”

Section: Discussionmentioning

confidence: 99%

“…TILs and TAMs are highly correlated with survival in breast cancer 3 . Studies on colorectal cancers have demonstrated a negative correlation between TILs and NLR, 4,5 but findings are not replicated in cohorts of breast and ovarian cancers 6–8 . It is also uncertain whether NLR and TIL counts are closely related measures of the tumour microenvironment or that they are distinct factors with independent prognostic values.…”

Section: Introductionmentioning

confidence: 99%

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Neutrophil–lymphocyte ratio reflects tumour‐infiltrating lymphocytes and tumour‐associated macrophages and independently predicts poor outcome in breast cancers with neoadjuvant chemotherapy

Li,

Ni,

Tsang

et al. 2024

Histopathology

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AimsThe neutrophil–lymphocyte ratio (NLR) is a systemic reflection of cancer‐associated inflammation and a prognostic marker for breast cancer. For the local tumour microenvironment, tumour‐infiltrating lymphocytes (TILs) and tumour‐associated macrophages (TAMs) are also highly correlated with breast cancer survival. This study aimed to explore the relationship between the circulating and local immune microenvironment, and to further delineate the prognostic role of NLR in breast cancer patients receiving neoadjuvant chemotherapy (NAC).MethodsA cohort of breast cancer patients receiving NAC with subsequent surgery was retrieved. Clinical data were reviewed. Histological slides and CD8 immunohistochemistry from biopsy (pre‐chemotherapy) and excision (postchemotherapy) specimens were assessed for TILs and TAMs.ResultsA total of 146 patients were included. There was a significant positive correlation between pre‐ and postsurgery NLR at a cut‐off of 2.6 (median pre‐chemotherapy NLR) (P < 0.001). NLR pre‐chemotherapy was associated positively with necrosis on biopsy (P = 0.027) and excision (P = 0.021) and TAMs on excision (P = 0.049). NLR 1 year postsurgery was associated with high tumour stage (P = 0.050) and low histological grade (P = 0.008). TIL count was lower in NLR‐high cases at almost all time‐points by histological assessment and CD8 immunostaining (P < 0.050). In multivariate analysis, postsurgery NLR is an independent predictor for overall survival [OS; hazard ratio (HR) = 9.524, P < 0.001], breast cancer‐specific survival (BCSS) (HR = 10.059, P = 0.001) and disease‐free survival (DFS; HR = 2.824, P = 0.016).ConclusionsThe association between NLR with tumour necrosis, TAMs and TILs illustrates an interaction between the circulating and local immune microenvironment. Late NLR is a strong indicator of outcome and may be useful for prognostication and disease monitoring.

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Section: Discussionmentioning

confidence: 95%