Preoperative elevated neutrophil-to-lymphocyte ratio (NLR) and derived NLR are associated with poor prognosis in patients with breast cancer

Duan, Junwu; Pan, Linlin; Ming, Yang

doi:10.1097/md.0000000000013340

Cited by 77 publications

(59 citation statements)

References 46 publications

(51 reference statements)

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“…The results of our studies were in line with NSCLC treated with chemotherapy, nivolumab, and EGFR‐ tyrosine kinase inhibitors (TKIs) . Furthermore, the trend were same in breast cancer, colorectal cancer and liver cancer . Anti‐PD‐1 Nivolumab can induce cancer cell apoptosis via T‐cell activation and EGFR‐TKIs could inhibit the combination of tyrosine kinase and adenosine triphosphate (ATP).…”

Section: Discussionsupporting

confidence: 71%

“…As platelets are part of the inflammation process, paraneoplastic thrombocytosis is common in solid cancer . There were some reports about the relationship between inflammation and prognosis, including neutrophils, lymphocytes, platelets and the combinations between them, such as neutrophils‐to‐lymphocytes rate (NLR), derived NLR (dNLR), platelets‐to‐lymphocytes rate (PLR) . In addition, hemoglobin (HGB) has been discovered to have an impact on prognosis, either .…”

Section: Introductionmentioning

confidence: 99%

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The value of blood biomarkers of progression and prognosis in ALK‐positive patients with non–small cell lung cancer treated with crizotinib

Yang

Gao

et al. 2019

Asia-Pac J Clncl Oncology

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Aim: Valuable and convenient prognostic predictors are essential for targeted therapy of nonsmall cell lung cancer (NSCLC). Patients with early-stage cancer and EGFR mutations who's neutrophils-to-lymphocytes rate (NLR) could be prognostic factor to evaluate efficacy. However, the prognostic role of NLR in patients receiving ALK inhibitors has not been established. Additionally, the relation between the efficacy of ALK inhibitors and derived NLR (dNLR), platelets-tolymphocytes rate (PLR), white blood cells (WBC) and hemoglobin (HGB) are still unknown.Methods: This is a retrospective single-center study and enrolled 113 staged IIIB-IV ALK-positive NSCLC patients who had received crizotinib treatment. Pretreatment NLR, dNLR, PLR, WBC, HGB were collected and calculated. Cox regression analysis were conducted to study the prognostic roles of NLR, dNLR, PLR, WBC, and HGB on progression-free survival (PFS) and overall survival (OS). Z-test was utilized to identify the difference among all predictive factors' receiver-operating characteristics (ROC) curves. Results:The median PFS and OS were 10.1 and 23.4 months. Elevated NLR, dNLR, PLR and decreased HGB were associated with worse PFS (95% confidence interval [CI], 1.078-2.304, P = 0.018; 95% CI, 1.043-2.222, P = 0.028; 95% CI, 1.257-2.757, P = 0.002; 95% CI, 0.368-0.843, P = 0.005, respectively) and OS (95% CI, 1.698-5.721, P < 0.001; 95% CI, 1.273-3.984, P = 0.005; 95% CI, 2.174-6.347, P < 0.001; 95% CI, 0.246-0.710, P = 0.001, respectively). Z-test revealed there were no significant differences between single factors or combination of them to predict the efficacy. Conclusions:Trend of NLR, dNLR, PLR and WBC could be used to identify patients progress status in ALK-positive NSCLC patients receiving crizotinib. Combination of all biomarkers is no superior to single biomarker. K E Y W O R D Sanaplastic lymphoma kinase inhibitor, derived NLR, neutrophils-to-lymphocytes rate, non-small cell lung cancer, platelets-to-lymphocytes rate Rearrangement of anaplastic lymphoma kinase (ALK) gene is one of the main targets in NSCLC, the most common of which is EML4-ALK Asia-Pac J Clin Oncol. 2020;16:63-69.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

The value of blood biomarkers of progression and prognosis in ALK‐positive patients with non–small cell lung cancer treated with crizotinib

Yang

Gao

et al. 2019

Asia-Pac J Clncl Oncology

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“…By contrast, in other molecular BC subtypes (luminal subtype: ER+ and/ or PR+ and HER2-; HER2-positive subtype: HER2+), no significant association between the NLR or the LMR and survival (DFS or OS) was identified [6]. Duan et al [7] also confirmed the role of the preoperative NLR as a predictive biomarker for prognosis in patients with BC. The NLR can also be a predictor of a pathologically completer response to neoadjuvant chemotherapy, especially with triple-negative BC [8].…”

Section: Discussionmentioning

confidence: 98%

Prognostic Value of the Neutrophil-Lymphocyte, Platelet-Lymphocyte, and Monocyte-Lymphocyte Ratios in Male Breast Cancer Patients

Huszno¹,

Kołosza²,

Mrochem-Kwarciak³

et al. 2020

Oncology

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Background:The aim of the present study was to assess the blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) as prognostic factors in male breast cancer (BC) patients. Methods: A retrospective analysis of 38 male BC patients who were treated at the Institute of Oncology (Gliwice, Poland) between January 2005 and December 2018 was performed. The prognostic value (in terms of overall survival [OS]) of the pretreatment PLR, NLR, and MLR was assessed by univariate analysis. Results: We observed a tendency towards worse OS among male BC patients with lymph node metastases (N+) (5-year OS: 43.5 vs. 73.9%; p = 0.087), a greater tumor size (T4 vs. T1 + T2) (42.0 vs. 70.5%; p = 0.061), and a negative steroid receptor status (PR-) (28.6 vs. 65.6%; p = 0.109). Patients with a family history of cancer had significantly better 5-year OS than patients without a family history of cancer (86.3 vs. 35.0%; p = 0.001). Younger male BC patients (age ≤56 years) had better 5-year OS than patients >56 years of age (82.5 vs. 42.3%; p = 0.028). The 5-year OS was lower among patients with a lower lymphocyte value (≤1.82 × 10 3 ) (29.0 vs. 75.6%; p = 0.010). There was a tendency towards worse OS among patients with a higher platelet count (>281 × 10 3 ) (4.5-year OS: 16.7 vs. 65.8%; p = 0.056). The 5-year OS was insignificantly lower in the group with NLRs >2.74 than in the group with NLRs ≤2.74 (37.5 vs. 62.8%; p = 0.078). A worse OS rate was associated with an elevated PLR (>169.1) (22.2 vs. 70.1%; p = 0.008). Similarly, there was worse OS in the group with higher MLR (>0.30) (41.8 vs. 78.3%; p = 0.025). Conclusions:The present results reveal that elevated MLRs (>0.30) and PLRs (>169.1) are associated with poor OS among male BC patients. Similarly, but insignificantly, an elevated NLR (>2.74) affected OS.

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“…Several studies and a recent meta-analysis have confirmed and extend the prognostic role of NLR in breast cancer [113][114][115]. However, Ferroni et al [115] demonstrated that the NLR may represent a negative prognostic factor to define distant metastasis-free survival, especially in stage I breast cancer, but not for local recurrence.…”

Section: Neutrophilsmentioning

confidence: 95%

“…Following their suggestions, the NLR prognostic value should be regarded with caution, and additional studies are required to consolidate the clinical value of NLR. Nevertheless, in stage I patients the presence of a high NLR might raise the question as to whether they should be more aggressively managed [113][114][115]. Furthermore, a retrospective study was performed to investigate the role of NLR in breast cancer patients receiving neoadjuvant chemotherapy [116]: the pCR rate in patients with low pre-treatment NLR (NLR < 2.06) was higher than in those with higher NLR (NLR ≥ 2.06) (24.5 vs.14.3%, p < 0.05).…”

Section: Neutrophilsmentioning

confidence: 99%

The Multifaceted Nature of Tumor Microenvironment in Breast Carcinomas

et al. 2020

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Heterogeneity in breast carcinomas can be appreciated at various levels, from morphology to molecular alterations, and there are well-known genotypic-phenotypic correlations. Clinical decision-making is strictly focused on the evaluation of tumor cells and is based on the assessment of hormone receptors and of the HER2 status, by means of a combination of immunohistochemical and in situ hybridization techniques. The tumor microenvironment (TME) also shows a multifaceted nature stemming from the different actors populating the intratumoral and the peritumoral stroma of breast carcinomas. Of note, we have now evidence that tumor-infiltrating lymphocytes (TILs) are clinically meaningful as their quantification in the intratumoral stroma strongly correlates with good prognosis, in particular in triple-negative and HER2-positive breast cancer patients. Nevertheless, TILs are just one of the many actors orchestrating the com-plexity of the TME, which is populated by immune and nonimmune cells (cancer-associated fibroblasts, cancer-associated adipocytes), as well as non-cellular components such as chemical inflammation mediators. In this review article we will overview the main features of the distinct cell compartments by discussing (i) the potential impact the TME may have on the prognostic stratification of breast cancers and (ii) the possible predictive value of some markers in the context of immunotherapy in light of the recent results of phase III studies in advanced and early triple-negative breast cancer patients.

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Preoperative elevated neutrophil-to-lymphocyte ratio (NLR) and derived NLR are associated with poor prognosis in patients with breast cancer

Cited by 77 publications

References 46 publications

The value of blood biomarkers of progression and prognosis in ALK‐positive patients with non–small cell lung cancer treated with crizotinib

The value of blood biomarkers of progression and prognosis in ALK‐positive patients with non–small cell lung cancer treated with crizotinib

Prognostic Value of the Neutrophil-Lymphocyte, Platelet-Lymphocyte, and Monocyte-Lymphocyte Ratios in Male Breast Cancer Patients

The Multifaceted Nature of Tumor Microenvironment in Breast Carcinomas

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