The prognostic significance of pretreatment neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with resectable non-metastatic breast cancer

摘要

Purpose: The objective of this trial is to explore the correlation between pretreatment neutrophil-to-lymphocyte ratio (NLR) and a platelet-to-lymphocyte ratio (PLR) and the disease-free survival (DFS) of patients with early resectable, non-metastatic breast cancer (BC) treated with neoadjuvant chemotherapy (NAC). Patients and methods: Receiver operating characteristic (ROC) curve analysis was utilized to determine an ideal cut-off value for NLR and PLR to discriminate between patients' DFS. Accordingly, 134 BC patients were classified into low and high NLR and PLR groups, respectively. Results: The ROC curve analysis determined 2.2 and 180 as optimal cut-off values for NLR and PLR respectively. On univariate analysis, both high NLR and PLR significantly correlated with poor DFS. On multivariate analysis, the significant prognostic value of high NLR continued (CI: 1.7-5.9, p 0.001), but not for PLR (CI: 0.5-1.6, p =0.595). Additionally, LNs involvement and high Ki-67 level significantly affect the DFS. The overall clinical response rate (RR) significantly correlated with the lower value of both NLR and PLR (p0.001 for both). Conclusion: The high NLR significantly correlated with poor DFS in patients with early non-metastatic BC treated with NAC, but PLR is not. As NLR is a clinical marker that can be easily applied and its high value was correlated with poor prognosis of early BC patients, NLR might be a potential predictor in patients’ outcome to assist in treatment decisions.