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RESEARCH PRODUCT

Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting

Marco MazzottaNicola TinariEriseld KrasniqiLaura IezziA. AmodioClara NatoliLaura PizzutiGiuseppe CiceroMaddalena BarbaVincenzo GrazianoPatrizia ViciAntonino GrassadoniaDaniele Marinelli

subject

0301 basic medicineOncologyAdultmedicine.medical_specialtyMultivariate analysisNeutrophilsQH301-705.5medicine.medical_treatmentBreast NeoplasmsArticleDisease-Free Survivalpredictive/prognostic biomarkers03 medical and health sciences0302 clinical medicineText miningBreast cancerluminal breast cancerInternal medicineMedicineHumansLymphocytesNeutrophil to lymphocyte ratioBiology (General)Neoadjuvant therapyAgedRetrospective StudiesChemotherapybusiness.industryProportional hazards modelallergologyfungiLuminal breast cancer; Neoadjuvant chemotherapy; Neutrophil to lymphocyte ratio (NLR); Predictive/prognostic biomarkers; Adult; Aged; Breast Neoplasms; Disease-Free Survival; Female; Humans; Ki-67 Antigen; Lymphocytes; Middle Aged; Multivariate Analysis; Neutrophils; Prognosis; Retrospective Studies; Treatment Outcome; Neoadjuvant TherapyHistologyGeneral MedicineMiddle Agedmedicine.diseasePrognosisneutrophil to lymphocyte ratio (NLR)Neoadjuvant Therapy030104 developmental biologyKi-67 AntigenTreatment Outcome030220 oncology & carcinogenesisMultivariate AnalysisPopulation studyFemalebusinessneoadjuvant chemotherapy

description

The neutrophil to lymphocyte ratio (NLR) is a promising predictive and prognostic factor in breast cancer. We investigated its ability to predict disease-free survival (DFS) and overall survival (OS) in patients with luminal A- or luminal B-HER2-negative breast cancer who received neoadjuvant chemotherapy (NACT). Pre-treatment complete blood cell counts from 168 consecutive patients with luminal breast cancer were evaluated to assess NLR. The study population was stratified into NLRlow or NLRhigh according to a cut-off value established by receiving operator curve (ROC) analysis. Data on additional pre- and post-treatment clinical-pathological characteristics were also collected. Kaplan–Meier curves, log-rank tests, and Cox proportional hazards models were used for statistical analyses. Patients with pre-treatment NLRlow showed a significantly shorter DFS (HR: 6.97, 95% CI: 1.65–10.55, p = 0.002) and OS (HR: 7.79, 95% CI: 1.25–15.07, p = 0.021) compared to those with NLRhigh. Non-ductal histology, luminal B subtype, and post-treatment Ki67 ≥ 14% were also associated with worse DFS (p = 0.016, p = 0.002, and p = 0.001, respectively). In a multivariate analysis, luminal B subtype, post-treatment Ki67 ≥ 14%, and NLRlow remained independent prognostic factors for DFS, while only post-treatment Ki67 ≥ 14% and NLRlow affected OS. The present study provides evidence that pre-treatment NLRlow helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT.

yearjournalcountryeditionlanguage
2021-07-03
10.3390/cells10071685http://hdl.handle.net/10447/520139