Increased neutrophil–lymphocyte ratio independently predicts poor survival in non‐metastatic triple‐negative breast cancer patients

Abstract

Inflammation plays an important role in tumor initiation, progression, and metastasis. The neutrophil-lymphocyte ratio (NLR) is widely used to evaluate global inflammation in various tumor types. However, the prognostic role of NLR in non-metastatic triple-negative breast cancer (TNBC) patients was poorly known. The aim of this study was to explore the association between pre-treatment NLR and survival in TNBC patients. Data were collected for patients with stages I-III TNBC from 2006 to 2013 at Linyi Central Hospital to analyze pre-treatment NLR and survival. Overall survival (OS) and disease-free survival (DFS) were estimated by the Kaplan-Meier method, and Cox analysis was performed to determine clinicopathological parameters for their prognostic relevance. A total of 406 patients were eligible. Patients with NLR lower than 2.85 exhibited significantly higher OS (P < 0.001) and DFS (P < 0.001) than patients with higher NLR. Higher pre-treatment NLR was independently correlated with poor OS and DFS, with hazard ratios of 2.69 (95% confidence interval [CI]: 1.94-3.72, P = 0.001) and 2.13 (95% CI: 1.68-2.65, P = 0.008), respectively, in the Cox proportional multivariate hazard model. In conclusion, our results indicate that pre-treatment NLR may be correlated with OS and DFS in early-stage TNBC patients, and that it may have considerable clinical applications. © 2018 IUBMB Life, 70(6):529-535, 2018.

Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review

“…Three (75%) showed that a high NLR was correlated with a shorter DFS in the univariate analyses [49][50][51]. In the multivariate analyses, two studies found a statistically significant correlation between NLR and DFS in patients with TNBC receiving adjuvant chemotherapy [49,50].…”

“…Most studies (n = 18; 78%) included patients with all BC molecular subtypes [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. four included only patients withTNBC [49][50][51][52], and one work included patients with onlyhormone receptor-negative BC (independently of the HER2 status) [53]. The NLR cut-off for the statistical analyses, computed by the ROC curves analysis in 78% of these studies, was between 1.34 and 4.…”

“…The number of enrolled patients varied from 90 to 1570. Fifteen studies (65%) reported data on Asian populations [32,35,36,38,39,[42][43][44][46][47][48][49]51,53]. The adjuvant chemotherapy regimens were described only in six studies (anthracycline-and/or taxane-based regimens) [33,38,43,45,48,51].…”

“…Studies including Specific BC Molecular Subtypes: four studies assessed OS in the function of the NLR in patients with TNBC [49][50][51][52]. Three (75%) showed that a high NLR was correlated with a shorter OS (univariate analysis) [49][50][51].…”

Controlling Nutritional Status (CONUT) score is a prognostic factor in patients with resected breast cancer

“…PNI and NLR are both reported scoring systems for the evaluation of the general condition of patients and have been demonstrated to be related with cancer survival, including breast cancer 2,28,29 . Comparisons between CONUT and PNI, previous results suggested that CONUT tended to be more superior to the PNI scoring systems for the prediction of survival in various cancer patients.…”