Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancer
Abstract Background Clinical utility of Ki-67 immunohistochemistry (IHC) in breast cancer (BC) is mainly limited to decide for the use of chemotherapy and estimate prognosis in patients with either Ki-67 index < 5% or > 30%; however, lacunae still exists pertaining to its analytical validity....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-12-01
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| Series: | Journal of the Egyptian National Cancer Institute |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43046-023-00200-4 |
| _version_ | 1797371169360314368 |
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| author | Radhika Arora Feroz Alam Atia Zaka-ur-Rab Veena Maheshwari Kiran Alam Mahboob Hasan |
| author_facet | Radhika Arora Feroz Alam Atia Zaka-ur-Rab Veena Maheshwari Kiran Alam Mahboob Hasan |
| author_sort | Radhika Arora |
| collection | DOAJ |
| description | Abstract Background Clinical utility of Ki-67 immunohistochemistry (IHC) in breast cancer (BC) is mainly limited to decide for the use of chemotherapy and estimate prognosis in patients with either Ki-67 index < 5% or > 30%; however, lacunae still exists pertaining to its analytical validity. Neutrophilia is common in cancer with accompanying lymphocytopenia. Neutrophil to lymphocyte ratio (NLR) captures the intricate balance between pro-tumor neutrophilia and anti-tumor lymphocyte immunity. This study aimed to correlate cellular proliferation in breast cancer with NLR. Methods An observational study was carried out including 73 cases of BC; pre-treatment NLR and Ki-67 grading were performed. NLR < 3 was considered low, while ≥ 3 was high. The Ki-67 expression was graded as low ≤ 5%, intermediate 6–29%, or high ≥ 30%. Various clinico-pathological variables were studied, and the association of categorical variables was analyzed using Pearson’s chi-square test, and a p-value of < 0.05 was taken as significant. Results Ki-67 correlated significantly with modified Scarff-Bloom-Richardson (SBR) grade (p < 0.01), and tumor-node-metastasis (TNM) stage (p < 0.001). Correlation of NLR was not significant with SBR grade (p > 0.05) and molecular subtype (p > 0.05); however, NLR was found to be significantly correlated with TNM stage (p < 0.001) and Ki-67 (p < 0.001). Conclusion NLR is fast emerging as a personalized theranostic marker in breast cancer. Instead of determining a generalized cut-off value, individual baseline NLR and its dynamics with disease progression will help manage patients better, obviating some of the drawbacks associated with Ki-67. |
| first_indexed | 2024-03-08T18:15:57Z |
| format | Article |
| id | doaj.art-c261ad29e0644dfdbf6f42b8dd571f66 |
| institution | Directory Open Access Journal |
| issn | 2589-0409 |
| language | English |
| last_indexed | 2024-03-08T18:15:57Z |
| publishDate | 2023-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of the Egyptian National Cancer Institute |
| spelling | doaj.art-c261ad29e0644dfdbf6f42b8dd571f662023-12-31T12:11:46ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092023-12-013511610.1186/s43046-023-00200-4Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancerRadhika Arora0Feroz Alam1Atia Zaka-ur-Rab2Veena Maheshwari3Kiran Alam4Mahboob Hasan5Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim UniversityDepartment of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim UniversityDepartment of General Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim UniversityDepartment of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim UniversityDepartment of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim UniversityDepartment of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim UniversityAbstract Background Clinical utility of Ki-67 immunohistochemistry (IHC) in breast cancer (BC) is mainly limited to decide for the use of chemotherapy and estimate prognosis in patients with either Ki-67 index < 5% or > 30%; however, lacunae still exists pertaining to its analytical validity. Neutrophilia is common in cancer with accompanying lymphocytopenia. Neutrophil to lymphocyte ratio (NLR) captures the intricate balance between pro-tumor neutrophilia and anti-tumor lymphocyte immunity. This study aimed to correlate cellular proliferation in breast cancer with NLR. Methods An observational study was carried out including 73 cases of BC; pre-treatment NLR and Ki-67 grading were performed. NLR < 3 was considered low, while ≥ 3 was high. The Ki-67 expression was graded as low ≤ 5%, intermediate 6–29%, or high ≥ 30%. Various clinico-pathological variables were studied, and the association of categorical variables was analyzed using Pearson’s chi-square test, and a p-value of < 0.05 was taken as significant. Results Ki-67 correlated significantly with modified Scarff-Bloom-Richardson (SBR) grade (p < 0.01), and tumor-node-metastasis (TNM) stage (p < 0.001). Correlation of NLR was not significant with SBR grade (p > 0.05) and molecular subtype (p > 0.05); however, NLR was found to be significantly correlated with TNM stage (p < 0.001) and Ki-67 (p < 0.001). Conclusion NLR is fast emerging as a personalized theranostic marker in breast cancer. Instead of determining a generalized cut-off value, individual baseline NLR and its dynamics with disease progression will help manage patients better, obviating some of the drawbacks associated with Ki-67.https://doi.org/10.1186/s43046-023-00200-4Ki-67NLRBreast cancerPrognosisPersonalized biomarker |
| spellingShingle | Radhika Arora Feroz Alam Atia Zaka-ur-Rab Veena Maheshwari Kiran Alam Mahboob Hasan Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancer Journal of the Egyptian National Cancer Institute Ki-67 NLR Breast cancer Prognosis Personalized biomarker |
| title | Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancer |
| title_full | Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancer |
| title_fullStr | Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancer |
| title_full_unstemmed | Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancer |
| title_short | Peripheral Neutrophil to Lymphocyte Ratio (NLR), a cogent clinical adjunct for Ki-67 in breast cancer |
| title_sort | peripheral neutrophil to lymphocyte ratio nlr a cogent clinical adjunct for ki 67 in breast cancer |
| topic | Ki-67 NLR Breast cancer Prognosis Personalized biomarker |
| url | https://doi.org/10.1186/s43046-023-00200-4 |
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