Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting
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 chemot...
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MDPI AG
2021-07-01
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| Online Access: | https://www.mdpi.com/2073-4409/10/7/1685 |
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| author | Antonino Grassadonia Vincenzo Graziano Laura Iezzi Patrizia Vici Maddalena Barba Laura Pizzuti Giuseppe Cicero Eriseld Krasniqi Marco Mazzotta Daniele Marinelli Antonella Amodio Clara Natoli Nicola Tinari |
| author_facet | Antonino Grassadonia Vincenzo Graziano Laura Iezzi Patrizia Vici Maddalena Barba Laura Pizzuti Giuseppe Cicero Eriseld Krasniqi Marco Mazzotta Daniele Marinelli Antonella Amodio Clara Natoli Nicola Tinari |
| author_sort | Antonino Grassadonia |
| collection | DOAJ |
| 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 NLR<sup>low</sup> or NLR<sup>high</sup> 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 NLR<sup>low</sup> showed a significantly shorter DFS (HR: 6.97, 95% CI: 1.65–10.55, <i>p</i> = 0.002) and OS (HR: 7.79, 95% CI: 1.25–15.07, <i>p</i> = 0.021) compared to those with NLR<sup>high</sup>. Non-ductal histology, luminal B subtype, and post-treatment Ki67 ≥ 14% were also associated with worse DFS (<i>p</i> = 0.016, <i>p</i> = 0.002, and <i>p</i> = 0.001, respectively). In a multivariate analysis, luminal B subtype, post-treatment Ki67 ≥ 14%, and NLR<sup>low</sup> remained independent prognostic factors for DFS, while only post-treatment Ki67 ≥ 14% and NLR<sup>low</sup> affected OS. The present study provides evidence that pre-treatment NLR<sup>low</sup> helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT. |
| first_indexed | 2024-03-10T09:43:10Z |
| format | Article |
| id | doaj.art-713b65d2ce5f42d89be1c7dd4cc06e10 |
| institution | Directory Open Access Journal |
| issn | 2073-4409 |
| language | English |
| last_indexed | 2024-03-10T09:43:10Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cells |
| spelling | doaj.art-713b65d2ce5f42d89be1c7dd4cc06e102023-11-22T03:28:23ZengMDPI AGCells2073-44092021-07-01107168510.3390/cells10071685Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant SettingAntonino Grassadonia0Vincenzo Graziano1Laura Iezzi2Patrizia Vici3Maddalena Barba4Laura Pizzuti5Giuseppe Cicero6Eriseld Krasniqi7Marco Mazzotta8Daniele Marinelli9Antonella Amodio10Clara Natoli11Nicola Tinari12Center for Advanced Studies and Technology (CAST), Department of Innovative Technologies in Medicine & Dentistry, G. D’Annunzio University, 66100 Chieti, ItalyCancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UKCenter for Advanced Studies and Technology (CAST), Department of Innovative Technologies in Medicine & Dentistry, G. D’Annunzio University, 66100 Chieti, ItalyDivision of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyDivision of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyDivision of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyDepartment of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, ItalyDivision of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyDivision of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyOncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University, 00185 Rome, ItalyDivision of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyCenter for Advanced Studies and Technology (CAST), Department of Innovative Technologies in Medicine & Dentistry, G. D’Annunzio University, 66100 Chieti, ItalyCenter for Advanced Studies and Technology (CAST), Department of Medical, Oral and Biotechnological Sciences, G. D’Annunzio University, 66100 Chieti, ItalyThe 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 NLR<sup>low</sup> or NLR<sup>high</sup> 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 NLR<sup>low</sup> showed a significantly shorter DFS (HR: 6.97, 95% CI: 1.65–10.55, <i>p</i> = 0.002) and OS (HR: 7.79, 95% CI: 1.25–15.07, <i>p</i> = 0.021) compared to those with NLR<sup>high</sup>. Non-ductal histology, luminal B subtype, and post-treatment Ki67 ≥ 14% were also associated with worse DFS (<i>p</i> = 0.016, <i>p</i> = 0.002, and <i>p</i> = 0.001, respectively). In a multivariate analysis, luminal B subtype, post-treatment Ki67 ≥ 14%, and NLR<sup>low</sup> remained independent prognostic factors for DFS, while only post-treatment Ki67 ≥ 14% and NLR<sup>low</sup> affected OS. The present study provides evidence that pre-treatment NLR<sup>low</sup> helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT.https://www.mdpi.com/2073-4409/10/7/1685luminal breast cancerneoadjuvant chemotherapyneutrophil to lymphocyte ratio (NLR)predictive/prognostic biomarkers |
| spellingShingle | Antonino Grassadonia Vincenzo Graziano Laura Iezzi Patrizia Vici Maddalena Barba Laura Pizzuti Giuseppe Cicero Eriseld Krasniqi Marco Mazzotta Daniele Marinelli Antonella Amodio Clara Natoli Nicola Tinari Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting Cells luminal breast cancer neoadjuvant chemotherapy neutrophil to lymphocyte ratio (NLR) predictive/prognostic biomarkers |
| title | Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting |
| title_full | Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting |
| title_fullStr | Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting |
| title_full_unstemmed | Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting |
| title_short | Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting |
| title_sort | prognostic relevance of neutrophil to lymphocyte ratio nlr in luminal breast cancer a retrospective analysis in the neoadjuvant setting |
| topic | luminal breast cancer neoadjuvant chemotherapy neutrophil to lymphocyte ratio (NLR) predictive/prognostic biomarkers |
| url | https://www.mdpi.com/2073-4409/10/7/1685 |
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