Prognostic role of high neutrophil-to-lymphocyte ratio in breast cancer patients receiving neoadjuvant chemotherapy

Xue, Ling; Y, Liu; Zhang, Bo; Yang, Yan; Yang, Dong; Zhang, Li Wei; Jin, Jian; Li, Jie

doi:10.1097/md.0000000000013842

Cited by 29 publications

(19 citation statements)

References 16 publications

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“…The NL ratio has been accepted as a predictive biomarker for prognosis in several cancers. In a meta-analysis, a high NL ratio was shown to be statistically significantly associated with poor response to NAC in breast cancer patients [47]. Rivas and colleagues have shown the NL ratio might be a predictive biomarker for tumor response in luminal B breast cancer patients receiving neoadjuvant therapy [48].…”

Section: Discussionmentioning

confidence: 99%

Is insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?

et al. 2020

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Purpose Neoadjuvant chemotherapy is the standard front-line treatment modality in locally advanced breast cancer. Achieving pathological complete response (pCR) is a significant prognostic factor for prolonged disease-free and overall survival. Insulin resistance is defined as a pathological condition in which insulin effect is impaired in peripheral target tissues such as the skeletal muscle, liver, and adipose tissue. The relationship between breast cancer and insulin resistance is controversial. In this study, our aim is to evaluate the role of insulin resistance, body mass index (BMI), metabolic syndrome, and inflammation markers to predict complete response in breast cancer patients who underwent neoadjuvant treatment. Methods Data from 55 locally advanced non-diabetic breast cancer patients, treated with neoadjuvant chemotherapy between 2015 and 2017, were retrospectively evaluated. Homeostatic model assessment, IR = insulin resistance (HOMA-IR) was calculated by using the obtained insulin and fasting blood glucose values before neoadjuvant chemotherapy (fasting insulin × fasting glucose/405). We considered a cut-off of 2.5 for insulin resistance. The systemic inflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were calculated. Results Twenty-five patients had no insulin resistance. The most common pathologic subtype (56%) was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (Her-2)-negative invasive ductal carcinoma. Sixteen (29%) patients had a pathological complete response (pCR). We found that the probability of pCR in patients with insulin resistance was 4.7 times lower than that in patients without insulin resistance [OR: 4.7 (95%CI 1.7–17.2), p = 0.01]. Conclusion Our results revealed that insulin resistance may have a negative effect on pathological complete response (pCR) following neoadjuvant therapy particularly with hormone-positive and Her-2-negative cases of non-diabetic breast cancer.

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Section: Discussionmentioning

confidence: 99%

Is insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?

et al. 2020

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“…14 Xue et al found that preoperative neutrophil elevation, patients with poor prognosis, short survival time. 15 In Li Sen's study, they found that neutrophils enhance the migration, invasiveness and epithelial-mesenchymal transition (EMT) of gastric cancer (GC) cells through IL-17a ( Figure 1A-C). 16 Under normal circumstances, lymphocytosis is more common in children.…”

Section: Common Hematological Parameters In Peripheral Blood White Blmentioning

confidence: 97%

<p>The Research Progress on the Prognostic Value of the Common Hematological Parameters in Peripheral Venous Blood in Breast Cancer</p>

Chen

Kong

Yan

et al. 2020

OTT

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Breast carcinoma is one of the most malignant tumors, severely influencing the physical and mental health of people. The latest epidemiological and clinical studies have found that breast tumor and inflammation are determinate relationships with each other. Inflammation is an essential component of the tumor microenvironment, and the change of inflammatory cells might influence tumor progression, such as neoplastic cell proliferation, migration, invasion, the collapse of antitumor immunity, metastasis and so forth. Peripheral blood tests at the time of diagnosis and treatment can reflect inflammatory conditions within the neoplasm. Evaluation of peripheral blood parameters including white blood cell, neutrophil, lymphocyte, monocyte, platelet counts, as well as neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (d-NLR) (neutrophil count divided by the result of white blood cell count minus neutrophil count), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR), which are indicators of systematic inflammatory response, have been widely proposed as prognostic factors for many malignancies. To intensively study the relationship between the common markers in peripheral blood and the treatment or prognosis of breast cancer will have critical clinical significance and application prospect, and can provide useful information for the clinicians. Herein, we review the research progress in the prognostic role of the peripheral blood in breast cancer to provide a new method for the treatment and prognosis of breast cancer.

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“…In the last few years, inflammatory blood markers have emerged as predictive and prognostic factors, particularly the neutrophil to lymphocyte ratio (NLR); that is, the ratio between the absolute neutrophil count and the absolute lymphocyte count. Lymphopenia and a high NLR before chemotherapy initiation have been inconsistently associated with worse responses to neo-adjuvant chemotherapy and with poor prognoses of different cancer types, including BC [3,4].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review

Corbeau

Jacot

Guiu

2020

Cancers

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Inflammatory blood markers (IBM), such as the neutrophil to lymphocyte ratio (NLR), have emerged as potential prognostic factors in various cancers, including breast cancer (BC), potentially allowing an easy, minimally invasive evaluation of a given cancer‘s prognosis and treatment outcome. We report here a systematic overview of the published data evaluating NLR as a prognostic factor or predictive factor for pathological complete response (PCR) and toxicity in early and advanced BC. A total of 45 articles were identified. NLR was found to be an independent prognostic factor for survival in most of the adjuvant treatment studies. However, no significant correlation was found between survival and NLR for early BC patients receiving neo-adjuvant chemotherapy (NACT) and advanced BC patients. Most studies failed to find a significant correlation between NLR and PCR after NACT. Finally, some data showed that IBM could be predictive of chemotherapy-related toxicity.

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Prognostic role of high neutrophil-to-lymphocyte ratio in breast cancer patients receiving neoadjuvant chemotherapy

Cited by 29 publications

References 16 publications

Is insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?

Is insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?

<p>The Research Progress on the Prognostic Value of the Common Hematological Parameters in Peripheral Venous Blood in Breast Cancer</p>

Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review

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