A nomogram based on platelet-to-lymphocyte ratio for predicting pathological complete response of breast cancer after neoadjuvant chemotherapy

Abstract

Objective To investigate the role of platelet-to-lymphocyte ratio (PLR) in complete pathological response (pCR) of breast cancer (BC) patients after neoadjuvant chemotherapy (NAC), as well as to establish and validate a nomogram for predicting pCR. Methods BC patients diagnosed and treated in the First Affiliated Hospital of Xi’an Jiaotong University from January 2019 to June 2022 were included. The correlation between pCR and clinicopathological characteristics was analyzed by Chi-square test. Logistic regression analysis was performed to evaluate the factors that might affect pCR. Based on the results of regression analysis, a nomogram for predicting pCR was established and validated. Results A total of 112 BC patients were included in this study. 50.89% of the patients acquired pCR after NAC. Chi-square test showed that PLR was significantly correlated with pCR (X2 = 18.878, P < 0.001). And the PLR before NAC in pCR group was lower than that in Non-pCR group (t = 3.290, P = 0.001). Logistic regression analysis suggested that white blood cell (WBC) [odds ratio (OR): 0.19, 95% confidence interval (CI): 0.04–0.85, P = 0.030)], platelet (PLT) (OR: 0.19, 95%CI: 0.04–0.85, P = 0.030), PLR (OR: 0.18, 95%CI: 0.04–0.90, P = 0.036) and tumor grade (OR: 9.24, 95%CI: 1.89–45.07, P = 0.006) were independent predictors of pCR after NAC. A nomogram prediction model based on WBC, PLR, PLR and tumor grade showed a good predictive ability. Conclusion PLR, PLT, WBC and tumor grade were independent predictors of pCR in BC patients after NAC. The nomogram based on the above positive factors showed a good predictive ability.

Predictive value of pretreatment circulating inflammatory response markers in the neoadjuvant treatment of breast cancer: meta-analysis

“…A total of seven studies investigated the WCC or its individual components ( Tables S3–S6 ) 19 , 23 , 24 , 32 , 33 , 36 , 50 ; one study included only patients with HER2+ breast cancer 19 , whereas the others included all subtypes.…”

“…A total of three studies 19 , 23 , 33 were eligible for meta-analysis of the association between the WCC (using a cut-off value of between 6.13 × 10 9 /l and 8.66 × 10 9 /l) and a pCR. The meta-analysis suggested that patients with a low pretreatment WCC were more likely to achieve a pCR (OR 1.96 (95% c.i.…”

“…A total of six studies 19 , 23 , 24 , 33 , 36 , 50 were suitable for the meta-analysis of the lymphocyte count, including 983 patients, of which 252 achieved a pCR. These studies indicated an association between a high lymphocyte count and a pCR (OR 0.44 (95% c.i.…”

“…A total of four studies 19 , 23 , 33 , 36 investigated the association between the neutrophil count and a pCR. Meta-analysis of these four studies (629 patients with 190 pCR events) favoured a low neutrophil count for achieving a pCR; however, this association was not significant (OR 1.62 (95% c.i.…”

Prognostic significance of platelet-to-lymphocyte ratio (PLR) in patients with breast cancer treated with neoadjuvant chemotherapy: a meta-analysis

“…Kaytaz Tekyol et al found that PLR value was associated with chemotherapy sensitivity and could serve as a predictive marker of the therapeutic effect of NACT in BC 34. Similarly, Jarroudi et al showed that PLR was associated with OS and DFS in BC treated with NACT 43 74. However, some other studies reported that the PLR value has no significant predictive effect on pCR rate, DFS or OS in BC treated with NACT 25 48.…”