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. 2020 Dec 7;20(1):1206.
doi: 10.1186/s12885-020-07700-9.

Dynamic changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predicts breast cancer prognosis

Ju-Yeon Kim  1 , Eun Jung Jung  2 , Jae-Myung Kim  1 , Han Shin Lee  3 , Seung-Jin Kwag  1 , Ji-Ho Park  1 , Taejin Park  3 , Sang-Ho Jeong  3 , Chi-Young Jeong  1 , Young-Tae Ju  1
Affiliations

Dynamic changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predicts breast cancer prognosis

Ju-Yeon Kim et al. BMC Cancer. .

Abstract

Background: We aimed to identify whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are more useful predictors after initial intention to treat than at the time of diagnosis.

Methods: We collected the medical data of 533 patients. The results of the peripheral blood sampling before the primary treatments were labeled as initial cohort, and those obtained between 24 and 36 months after initial treatment were defined as the 2nd cohort. Delayed metastasis has been defined as distant metastasis 2 years after treatment, and survival outcome was estimated and compared across groups.

Results: Median follow-up duration was 74 months (24-162 months), and 53 patients experienced delayed metastasis. In univariate analysis, metastasis-free survival, patient age at diagnosis, tumor size, axillary lymph node metastasis, HER-2 status, initial NLR and PLR, and 2nd NLR and PLR were found to be significantly associated with delayed metastasis. However, in multivariate analysis, only the 2nd NLR and PLR were found to be significantly associated with delayed metastasis, excluding initial NLR and PLR. Metastasis-free survival was analyzed through the pattern changes of NLR or PLR. The results revealed that patients with continued low NLR and PLR values at pre- and post-treatment (low initial values and 2nd values) showed a significantly better prognosis than those with a change in value or continued high NLR and PLR.

Conclusions: We identified that patients with persistent high NLR and PLR after initial treatment have significant worse prognosis in terms of late metastasis. Therefore, these results suggest that NLR and PLR are more useful in predicting prognosis post-treatment.

Keywords: Biomarker; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Prognostic factor.

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Conflict of interest statement

All authors declare that there is no actual or potential conflict of interest.

Figures

Fig. 1
Fig. 1
Non-parametric analysis of LNR and PLR. a and b showed the distribution of initial and 2nd parameters. c and d showed the average difference in values according to delayed metastasis
Fig. 2
Fig. 2
Kaplan-Meier curves and log-rank tests comparing delayed metastasis free survival with different subgroups according to NLR and PLR changes
See this image and copyright information in PMC

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