Pretreatment neutrophil-lymphocyte ratio has prognosis value in breast cancer patients

Authors

DOI:

https://doi.org/10.33448/rsd-v11i9.31783

Keywords:

Breast cancer; Prognosis; Inflammation; Biomarkers; Survival.

Abstract

Objectives: This study aimed to determine the prognostic value of the pretreatment inflammatory indexes neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, and platelet-lymphocyte ratio in breast cancer. Methods: A retrospective cohort of patients with breast cancer receiving treatment at a specialized cancer hospital were collected from 2016. Pretreatment complete blood cell counts were evaluated to assess inflammatory indexes. The outcome variable was 5-year overall survival. Kaplan-Meier curves, log-rank test, and Cox regression (hazard ratio; 95% confidence interval) were used. Results: A total of 312 women (mean age 51.9 years; histopathological grade II 61.6%; tumor stage III 50.0%) were included in the study. Of these, 169 (54.2%) died within 5 years, the majority of whom had neutrophil-lymphocyte ratio ≥ 2.5 (62.5%; p= 0.002), histopathological grades II and III (60.4%; p= 0.024), more advanced tumor stages (87.7%; p<0.001), and significantly lower overall survival. Neutrophil-lymphocyte ratio ≥ 2.5 (hazard ratio, 1.53; 95% CI, 1.11-2.11) was an independent prognostic factor for overall survival. In addition, histopathological grades II (hazard ratio, 3.53; 95% confidence interval, 1.29-9.68) and III stage (hazard ratio, 2.50; 95% confidence interval, 1.45-4.34) and stage IV (hazard ratio, 6.07; 95% confidence interval, 3.43-10.73) demonstrated predictive power. Conclusion: Pretreatment neutrophil-lymphocyte ratio was considered a useful predictor of overall survival in breast cancer.

References

Allemani, C., Matsuda, T., Di Carlo, V., Harewood, R., Matz, M., Nikšić, M., Bonaventure, A., Valkov, M., Johnson, C. J., Estève, J., Ogunbiyi, O. J., Azevedo E Silva, G., Chen, W. Q., Eser, S., Engholm, G., Stiller, C. A., Monnereau, A., Woods, R. R., Visser, O., Lim, G. H., … CONCORD Working Group (2018). Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet (London, England), 391(10125), 1023–1075. https://doi.org/10.1016/S0140-6736(17)33326-3

Ayala, A., Anjos, J., Cassol, G. A., & Höfelmann, D. A. (2019). Sobrevida em 10 anos em mulheres com câncer de mama: coorte história de 2000-2014 [Survival rate of 10 years among women with breast cancer: a historic cohort from 2000-2014]. Ciencia & saude coletiva, 24(4), 1537–1550. https://doi.org/10.1590/1413-81232018244.16722017

Cao, X., Zhou, Y., Mao, F., Lin, Y., & Sun, Q. (2020). Combination of preoperative fibrinogen concentration and neutrophil-to-lymphocyte ratio for prediction of the prognosis of patients with resectable breast cancer. Oncology letters, 20(5), 200. https://doi.org/10.3892/ol.2020.12061

Chen, L., Kong, X., Wang, Z., Wang, X., Fang, Y., & Wang, J. (2020). Pre-treatment systemic immune-inflammation index is a useful prognostic indicator in patients with breast cancer undergoing neoadjuvant chemotherapy. Journal of cellular and molecular medicine, 24(5), 2993–3021. https://doi.org/10.1111/jcmm.14934

Cho, U., Park, H. S., Im, S. Y., Yoo, C. Y., Jung, J. H., Suh, Y. J., & Choi, H. J. (2018). Prognostic value of systemic inflammatory markers and development of a nomogram in breast cancer. PloS one, 13(7), e0200936. https://doi.org/10.1371/journal.pone.0200936

De Giorgi, U., Mego, M., Scarpi, E., Giordano, A., Giuliano, M., Valero, V., Alvarez, R. H., Ueno, N. T., Cristofanilli, M., & Reuben, J. M. (2019). Association between circulating tumor cells and peripheral blood monocytes in metastatic breast cancer. Therapeutic advances in medical oncology, 11, 1758835919866065. https://doi.org/10.1177/1758835919866065

DeSantis, C. E., Ma, J., Gaudet, M. M., Newman, L. A., Miller, K. D., Goding Sauer, A., Jemal, A., & Siegel, R. L. (2019). Breast cancer statistics, 2019. CA: a cancer journal for clinicians, 69(6), 438–451. https://doi.org/10.3322/caac.21583

Duan, J., Pan, L., & Yang, M. (2018). Preoperative elevated neutrophil-to-lymphocyte ratio (NLR) and derived NLR are associated with poor prognosis in patients with breast cancer: A meta-analysis. Medicine, 97(49), e13340. https://doi.org/10.1097/MD.0000000000013340

Ethier, J. L., Desautels, D., Templeton, A., Shah, P. S., & Amir, E. (2017). Prognostic role of neutrophil-to-lymphocyte ratio in breast cancer: a systematic review and meta-analysis. Breast cancer research : BCR, 19(1), 2. https://doi.org/10.1186/s13058-016-0794-1

Freitas, R., Júnior, Nunes, R. D., Martins, E., Curado, M. P., Freitas, N., Soares, L. R., & Oliveira, J. C. (2017). Prognostic factors and overall survival of breast cancer in the city of Goiania, Brazil: a population-based study. Revista do Colegio Brasileiro de Cirurgioes, 44(5), 435–443. https://doi.org/10.1590/0100-69912017005003

Gago-Dominguez, M., Matabuena, M., Redondo, C. M., Patel, S. P., Carracedo, A., Ponte, S. M., Martínez, M. E., & Castelao, J. E. (2020). Neutrophil to lymphocyte ratio and breast cancer risk: analysis by subtype and potential interactions. Scientific reports, 10(1), 13203. https://doi.org/10.1038/s41598-020-70077-z

Geng, S. K., Fu, S. M., Fu, Y. P., & Zhang, H. W. (2018). Neutrophil to lymphocyte ratio is a prognostic factor for disease free survival in patients with breast cancer underwent curative resection. Medicine, 97(35), e11898. https://doi.org/10.1097/MD.0000000000011898

Guo, W., Lu, X., Liu, Q., Zhang, T., Li, P., Qiao, W., & Deng, M. (2019). Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for breast cancer patients: An updated meta-analysis of 17079 individuals. Cancer medicine, 8(9), 4135–4148. https://doi.org/10.1002/cam4.2281

Höfelmann, D. A., Anjos, J. C. D., & Ayala, A. L. (2014). Sobrevida em dez anos e fatores prognósticos em mulheres com câncer de mama em Joinville, Santa Catarina, Brasil. Ciência & Saúde Coletiva, 19, 1813-1824. https://doi.org/10.1590/1413-81232014196.03062013

Huszno, J., Kołosza, Z., Mrochem-Kwarciak, J., & Zajusz, A. (2020). Prognostic Value of the Neutrophil-Lymphocyte, Platelet-Lymphocyte, and Monocyte-Lymphocyte Ratios in Male Breast Cancer Patients. Oncology, 98(7), 487–492. https://doi.org/10.1159/000505627

Jedy-Agba, E., McCormack, V., Adebamowo, C., & Dos-Santos-Silva, I. (2016). Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis. The Lancet. Global health, 4(12), e923–e935. https://doi.org/10.1016/S2214-109X(16)30259-5

Kim, J. Y., Jung, E. J., Kim, J. M., Lee, H. S., Kwag, S. J., Park, J. H., Park, T., Jeong, S. H., Jeong, C. Y., & Ju, Y. T. (2020). Dynamic changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predicts breast cancer prognosis. BMC cancer, 20(1), 1206. https://doi.org/10.1186/s12885-020-07700-9

Marín Hernández, C., Piñero Madrona, A., Gil Vázquez, P. J., Galindo Fernández, P. J., Ruiz Merino, G., Alonso Romero, J. L., & Parrilla Paricio, P. (2018). Usefulness of lymphocyte-to-monocyte, neutrophil-to-monocyte and neutrophil-to-lymphocyte ratios as prognostic markers in breast cancer patients treated with neoadjuvant chemotherapy. Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 20(4), 476–483. https://doi.org/10.1007/s12094-017-1732-0

Rakha, E. A., El-Sayed, M. E., Menon, S., Green, A. R., Lee, A. H., & Ellis, I. O. (2008). Histologic grading is an independent prognostic factor in invasive lobular carcinoma of the breast. Breast cancer research and treatment, 111(1), 121–127. https://doi.org/10.1007/s10549-007-9768-4

Roué, T., Labbé, S., Belliardo, S., Plenet, J., Douine, M., & Nacher, M. (2016). Predictive Factors of the Survival of Women With Invasive Breast Cancer in French Guiana: The Burden of Health Inequalities. Clinical breast cancer, 16(4), e113–e118. https://doi.org/10.1016/j.clbc.2016.02.017

Shalapour, S., & Karin, M. (2015). Immunity, inflammation, and cancer: an eternal fight between good and evil. The Journal of clinical investigation, 125(9), 3347–3355. https://doi.org/10.1172/JCI80007

Singh, K., He, X., Kalife, E. T., Ehdaivand, S., Wang, Y., & Sung, C. J. (2018). Relationship of histologic grade and histologic subtype with oncotype Dx recurrence score; retrospective review of 863 breast cancer oncotype Dx results. Breast cancer research and treatment, 168(1), 29–34. https://doi.org/10.1007/s10549-017-4619-4

Wariss, B. R., de Souza Abrahão, K., de Aguiar, S. S., Bergmann, A., & Thuler, L. (2017). Effectiveness of four inflammatory markers in predicting prognosis in 2374 women with breast cancer. Maturitas, 101, 51–56. https://doi.org/10.1016/j.maturitas.2017.04.015

Wei, B., Yao, M., Xing, C., Wang, W., Yao, J., Hong, Y., Liu, Y., & Fu, P. (2016). The neutrophil lymphocyte ratio is associated with breast cancer prognosis: an updated systematic review and meta-analysis. OncoTargets and therapy, 9, 5567–5575. https://doi.org/10.2147/OTT.S108419

Wiegert, E., de Oliveira, L. C., Calixto-Lima, L., Mota E Silva Lopes, M., & Peres, W. (2020). Cancer cachexia: Comparing diagnostic criteria in patients with incurable cancer. Nutrition (Burbank, Los Angeles County, Calif.), 79-80, 110945. https://doi.org/10.1016/j.nut.2020.110945

Zhang, M., Huang, X. Z., Song, Y. X., Gao, P., Sun, J. X., & Wang, Z. N. (2017). High Platelet-to-Lymphocyte Ratio Predicts Poor Prognosis and Clinicopathological Characteristics in Patients with Breast Cancer: A Meta-Analysis. BioMed research international, 2017, 9503025. https://doi.org/10.1155/2017/9503025

Zhang, W., Shen, Y., Huang, H., Pan, S., Jiang, J., Chen, W., Zhang, T., Zhang, C., & Ni, C. (2020). A Rosetta Stone for Breast Cancer: Prognostic Value and Dynamic Regulation of Neutrophil in Tumor Microenvironment. Frontiers in immunology, 11, 1779. https://doi.org/10.3389/fimmu.2020.01779

Downloads

Published

06/07/2022

How to Cite

SILVA, S. H. K. da; OLIVEIRA, L. C. de; PERES, W. A. F. .; WIEGERT, E. V. M. .; MOTTA, R. S. T.; SILVA, N. . F. da .; LOPES, M. S. da M. e S. . Pretreatment neutrophil-lymphocyte ratio has prognosis value in breast cancer patients . Research, Society and Development, [S. l.], v. 11, n. 9, p. e17611931783, 2022. DOI: 10.33448/rsd-v11i9.31783. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/31783. Acesso em: 22 dec. 2024.

Issue

Vol. 11 No. 9

Section

Health Sciences

License

Copyright (c) 2022 Sandra Helena Kaznowski da Silva; Livia Costa de Oliveira; Wilza Arantes Ferreira Peres; Emanuelly Varea Maria Wiegert; Rachel Souza Thompson Motta; Naira Freire da Silva; Márcia Soares da Mota e Silva Lopes

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.