Dataset Information

Clinical significance of the neutrophil-to-lymphocyte ratio in oligometastatic breast cancer.

ABSTRACT:

Purpose

This study investigated the clinical impact of pretreatment neutrophil-to-lymphocyte ratio (NLR) on survival in patients with oligometastatic breast cancer.

Patients and methods

We collected data from 397 patients who underwent primary breast surgery from 2004 to 2015 and developed recurrence during the follow-up. We reviewed the images and clinical information and defined OMD according to the European Society for Medical Oncology advanced breast cancer guidelines. The NLR was calculated using pretreatment data of primary breast cancer. The cutoff value of the NLR was determined by receiver operating characteristic curve with Youden Index.

Results

Among 397 patients, 131 had OMD at recurrence. The low-NLR group included patients of significantly older age at primary cancer than those in the high-NLR group. A low NLR indicated a better overall survival (p = 0.023) after adjusting for relevant factors, including estrogen receptor status, surgical resection of metastatic disease, metastatic organ number, disease-free interval, and liver metastasis than did the high-NLR group. We developed prognostic models for OMD using six independent prognostic factors, including the NLR. The number of factors was associated with overall survival; patients with all six favorable factors showed a good overall survival of 90.9% at 8 years and those with four or more factors showed 70.4%.

Conclusions

The NLR was an independent prognostic factor for overall survival in OMD. The number of favorable prognostic factors was associated with overall survival. A prognostic model, including the NLR, will help identify patients with a favorable prognosis.

SUBMITTER: Inoue Y

PROVIDER: S-EPMC9581831 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Clinical significance of the neutrophil-to-lymphocyte ratio in oligometastatic breast cancer.

Inoue Yuka Y Fujishima Makoto M Ono Makiko M Masuda Jun J Ozaki Yukinori Y Maeda Tetsuyo T Uehiro Natsue N Takahashi Yoko Y Kobayashi Takayuki T Sakai Takehiko T Osako Tomo T Ueno Takayuki T Ohno Shinji S

Breast cancer research and treatment 20220924 2

<h4>Purpose</h4>This study investigated the clinical impact of pretreatment neutrophil-to-lymphocyte ratio (NLR) on survival in patients with oligometastatic breast cancer.<h4>Patients and methods</h4>We collected data from 397 patients who underwent primary breast surgery from 2004 to 2015 and developed recurrence during the follow-up. We reviewed the images and clinical information and defined OMD according to the European Society for Medical Oncology advanced breast cancer guidelines. The NLR ...[more]

PMID: 36153381

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Project description:ObjectiveTo evaluate the diagnostic value of the expression of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in distinguishing endometrial cancer from benign uterine lesions.MethodsIn this retrospective analysis, clinical data were collected from 112 patients treated at Hengshui People's Hospital (Harrison International Peace Hospital) between January 2022 and December 2023. The cohort comprised 56 patients diagnosed with endometrial cancer and 56 patients with benign uterine lesions, matched 1:1. Demographic details, comorbidities, and serological parameters - including WBC, RBC, Hb, MPV, neutrophil, lymphocyte, monocyte, and platelet counts - were recorded. NLR, LMR, and PLR values were subsequently calculated.ResultsSignificant serological differences were observed between the endometrial cancer and benign lesion groups, including NLR (4.25 ± 1.23 vs. 2.18 ± 0.95, P < 0.001), LMR (3.12 ± 0.98 vs. 5.08 ± 1.75, P < 0.001), and PLR (201.23 ± 45.66 vs. 150.27 ± 30.45, P < 0.001). Correlation analysis indicated a strong association between endometrial cancer and NLR (r = 0.689, P < 0.001), LMR (r = -0.572, P < 0.001), and PLR (r = 0.552, P < 0.001). ROC analysis demonstrated that NLR (AUC = 0.91) offered superior diagnostic value relative to LMR (AUC = 0.841) and PLR (AUC = 0.83). Logistic regression identified significant associations for NLR ≥ 3.4 (OR = 69.173, P < 0.001), LMR ≥ 4.055 (OR = 0.048, P < 0.001), and PLR ≥ 150.445 (OR = 18.134, P = 0.002). DeLong's test revealed no significant differences in diagnostic performance among the ratios (NLR vs. LMR, P = 0.149; NLR vs. PLR, P = 0.08; LMR vs. PLR, P = 0.842).ConclusionNLR, LMR, and PLR are valuable hematological markers for diagnosing endometrial cancer, with NLR demonstrating the highest sensitivity and specificity. These findings support the inclusion of these serological parameters in routine diagnostic protocols to enhance the accurate identification of endometrial cancer.

Project description:Predicting survival of patients with malignant pleural effusions (MPEs) is notoriously difficult. A robust prognostic marker can guide clinical decision making. The neutrophil-to-lymphocyte ratio (NLR) in blood has been shown to predict survival in many cancers. Pleural fluid bathes the malignant pleural tissues, thus the NLR of the pleural fluid may reflect more closely the local tumour environment. The objective of this study was to explore the prognostic significance of pleural effusion NLR for MPE. We analysed matched effusion and blood from 117 patients with malignant and 24 with benign pleural effusions. Those who had received recent chemotherapy or had a pleurodesis were excluded. Neutrophil and lymphocyte counts in effusions were performed by manual review of cytospin cell preparations by trained observers. Clinical data were extracted from a state-wide hospital database. We found significantly fewer neutrophils (expressed as percentage of total leukocyte count) in pleural fluid than in corresponding blood (9% vs 73%; p<0.001). The NLR was an order of magnitude lower in pleural fluid than in corresponding blood: median [IQR] = 0.20 [0.04-1.18] vs 4.9 [3.0-8.3], p<0.001. Correlation between blood and pleural fluid NLR in MPE patients was moderate (rs = 0.321, p<0.001). In univariate analysis, NLR (>0.745)) in malignant pleural fluid was predictive of poorer survival (HR = 1.698 [1.0054-2.736]; p = 0.030), and remained significant after adjustment for age, sex, presence of a chest drain, cancer type, concurrent infection and subsequent treatment with chemotherapy (HR = 1.786 [1.089-2.928]; p = 0.022). Patients with pleural fluid NLR > 0.745 had a significantly shorter median survival of 130 (95% CI 0-282) days compared to 312 (95% CI 195-428) days for pleural NLR < 0.745, p = 0.026. The NLR in blood was also predictive of poorer survival in MPE patients (HR = 1.959 [1.019-3.096]; p<0.001). The proportion of neutrophils in pleural fluid was predictive of prognosis more strongly than lymphocytes. This study provides evidence that NLR in malignant effusions can predict survival, and therefore may provide prognostic information for this cohort. This prognostic association in the fluid is driven by the presence of neutrophils.

Project description:Peripheral blood-derived inflammation-based scores such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been proposed as prognostic markers in solid tumours. Although evidence to support these markers as unfavourable prognostic factors is more compelling in gastrointestinal cancers, very little is known of their impact on breast cancer. We investigated the association between the NLR and PLR, and overall survival after breast cancer.Data from the University of Malaya Medical Centre Breast Cancer Registry was used. Of 2059 consecutive patients diagnosed from 2000 to 2008, we included 1435 patients with an available pre-treatment differential blood count (∼70%). Patients were stratified into quintiles of the NLR/PLR. Multivariable Cox regression was used to determine the independent prognostic significances of the NLR/PLR.Compared with the first quintile of the NLR, women in quintile 5 were younger, had bigger tumours, nodal involvement, distant metastases and higher tumour grades. Higher NLR quintiles were significantly associated with poorer survival with a 5-year relative survival ratio (RSR) of 76.4% (95% CI: 69.6-82.1%) in quintile 1, 79.4% (95% CI: 74.4-83.7%) in quintile 2, 72.1% (95% CI: 66.3-77.3%) in quintile 3, 65.6% (95% CI: 59.8-70.8%) in quintile 4 and 51.1% (95% CI: 43.3-58.5%) in quintile 5. Following adjustment for demography, tumour characteristics, treatment and the PLR, the adjusted hazard ratio (HR) for quintile 5 vs quintile 1 was 1.50 (95% CI: 1.08-1.63); Ptrend=0.004. Results were unchanged when the NLR was analysed as a dichotomous variable using different cutoff points. Although patients in PLR quintile 5 had lower survival than in quintile 1 (5-year RSR: 53.2% (95% CI: 46.9-59.2%) vs 77.0% (95% CI: 70.9-82.2%)), this association was not significant after multivariable adjustment. However, a PLR >185 was significantly associated with poorer survival; adjusted HR: 1.25 (95% CI: 1.04-1.52).Both the NLR and PLR are independently associated with an increased risk of mortality in breast cancer. Their added value in the prognostication of breast cancer in clinical practice warrants investigation.

Dataset Information

Clinical significance of the neutrophil-to-lymphocyte ratio in oligometastatic breast cancer.

Purpose

Patients and methods

Results

Conclusions

Publications

Clinical significance of the neutrophil-to-lymphocyte ratio in oligometastatic breast cancer.

Similar Datasets

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