Prognostic role of derived neutrophil-to-lymphocyte ratio in surgical triple-negative breast cancer

Abstract

IntroductionThe role of derived neutrophil-to-lymphocyte ratio (dNLR) in predicting the prognosis of patients with triple-negative breast cancer (TNBC) has not been well studied. Here, we attempted to investigate the significance of dNLR in predicting the prognosis of patients with surgical (nonmetastatic) TNBC.MethodsA total of 281 patients diagnosed with surgical TNBC in The First Affiliated Hospital of University of Science and Technology of China from February 2005 to March 2015 were retrospectively included in this study. Kaplan–Meier curve analysis was used to assess the disease-free survival (DFS) and overall survival (OS). We used Cox regression model to assess the prognostic significance of pretreatment dNLR and other clinicopathological parameters in TNBC patients.ResultsThe median DFS in TNBC patients who had low dNLR and high dNLR was 28.9 and 15.1 months (P<0.001), respectively, whereas the median OS in patients who had low dNLR and high dNLR was 71.2 and 42.3 months (P<0.001), respectively. In patients aged ≤50 years and with invasive ductal carcinoma, a low dNLR predicted better DFS and OS compared with a high dNLR. Multivariate analysis demonstrated that the increased dNLR was a risk factor of poor DFS (HR=1.90, 95% CI: 1.52–2.46, P=0.007) and OS (HR=2.56, 95% CI: 1.69–3.58, P=0.001).ConclusionPretreatment dNLR is an independent factor of prognosis for TNBC patients, which potentially allows clinical doctors to improve outcomes of patients with high dNLR by treating with aggressive therapy, such as high-dose adjuvant chemotherapy and radiotherapy.

Epigenetic Quantification of Circulating Immune Cells in Peripheral Blood of Triple-Negative Breast Cancer patients

“…This nding agrees with that from a previous study, which reported mdNLR values of 2.7 in TNBC cases and 2.4 in controls (3). A high NLR was associated with adverse survival of patients affected by various solid tumors, including TNBC (5,7,9,17). Howeverin contrast to the previous studies, mdNLR was not an independent predictor of OS in our study.…”

“…For instance, an increased neutrophil-to-lymphocyte ratio (NLR) which is indicative of systemic in ammation, could promote cancer cell proliferation, angiogenesis, cellular migration, and metastasis (6). There is evidence from many studies for a prognostic role of NLR in peripheral blood of various cancer patients (7)(8)(9)(10), including breast cancer (8,11,12).…”

Monocyte to Lymphocyte Ratio, Neutrophil to Lymphocyte Ratio, and Red Cell Distribution Width are the Associates with Gouty Arthritis

“…The presence and prognosis of systemic inflammation are increased by elevated C-reactive protein (CRP), leukocyte, platelet, ferritin and decreased albumin levels (9). Neutrophils, monocytes, and macrophages migrate to the site of inflammation, causing inflammation by releasing some cytokines and chemokines (8).…”

Biomarkers Derived From Routine Blood Cell Counts Differentially Predict Disease-Free and Overall Survival After Neoadjuvant Treatment of Triple-Negative Breast Cancer

“…NLR measured before the start of neoadjuvant chemotherapy (NLR1) was the only independent prognostic serologic marker for prediction of survival. In previous neoadjuvant studies it has not been shown unequivocally that in TNBC NLR1 is an independent factor predicting survival (both DFS and OS) 9,11,14,19,20,21,22,23,24,25 ; however, a recent analysis of Bae et colleagues presented on a greater cohort this independent association 13 (Table 6). It was suggested that incorporating PLR may also be important predicting survival 26,27 .…”