J Breast Cancer.  2013 Mar;16(1):55-59.

Usefulness of Pretreatment Neutrophil to Lymphocyte Ratio in Predicting Disease-Specific Survival in Breast Cancer Patients

• Noh H
• Eomm M
• Han A

Abstract

PURPOSE
The purpose of this study was to investigate the prognostic impact of pretreatment neutrophil to lymphocyte ratio (NLR) on breast cancer in view of disease-specific survival and the intrinsic subtype.
METHODS
We retrospectively studied patients diagnosed with primary breast cancer that had completed all phases of primary treatment from 2000 to 2010. The association between pretreatment NLR and disease-specific survival was analyzed.
RESULTS
A total of 442 patients were eligible for analysis. Patients with higher NLR (2.5 < or =NLR) showed significantly lower disease-specific survival rate than those with lower NLR (NLR <2.5). Higher NLR along with negative estrogen receptor status and positive nodal status were independently correlated with poor prognosis, with hazard ratio 4.08 (95% confidence interval [CI], 1.62-10.28), 9.93 (95% CI, 3.51-28.13), and 11.23 (95% CI, 3.34-37.83), respectively. Luminal A subtype was the only intrinsic subtype in which higher NLR patients showed significantly poor prognosis (87.7% vs. 96.7%, p=0.009).
CONCLUSION
Patients with an elevated pretreatment NLR showed poorer disease-specific survival than patients without elevated NLR, most evident in the luminal A subtype. Further validation and a feasibility study are required before it can be considered for clinical use.

Keyword

Breast neoplasms; Lymphocytes; Neutrophils

MeSH Terms

Breast
Breast Neoplasms
Estrogens
Humans
Lymphocytes
Neutrophils
Phenobarbital
Prognosis
Retrospective Studies
Survival Rate
Estrogens
Phenobarbital

Figure

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  Figure 1 Enrollment and outcomes. We identified 502 patients who were diagnosed and completed the treatment of breast cancer; and 442 patients were eligible for analysis. HG=histologic grade; HR=hormonal receptor; HER2=human epidermal growth factor receptor 2.

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  Figure 2 Disease-specific survival curves stratified by neutrophil to lymphocyte ratio (NLR). Kaplan-Meier estimates for disease-specific survival stratified by NLR.

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  Figure 3 Disease-specific survival curves stratified by neutrophil to lymphocyte ratio (NLR) of luminal A subtype. Kaplan-Meier estimates for disease-specific survival stratified by NLR of luminal A subtype.

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