DOI QR코드

DOI QR Code

The Neutrophil to Lymphocyte Ratio has a High Negative Predictive Value for Pathologic Complete Response in Locally Advanced Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

  • Eryilmaz, Melek Karakurt (Department of Medical Oncology, Akdeniz University School of Medicine) ;
  • Mutlu, Hasan (Department of Medical Oncology, Akdeniz University School of Medicine) ;
  • Salim, Derya Kivrak (Department of Medical Oncology, Akdeniz University School of Medicine) ;
  • Musri, Fatma Yalcin (Department of Medical Oncology, Akdeniz University School of Medicine) ;
  • Tural, Deniz (Department of Medical Oncology, Akdeniz University School of Medicine) ;
  • Coskun, Hasan Senol (Department of Medical Oncology, Akdeniz University School of Medicine)
  • 발행 : 2014.10.11

초록

Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with pancreatic, colorectal, lung, gastric cancer and renal cell carcinoma. The aim of this study was to determine the relationship between pathological complete response (pCR) and pretreatment NLR values in locally advanced breast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT). Materials and Methods: Datawere collected retrospectively from the Akdeniz University School of Medicine Database for locally advanced BC patients treated with NACT between January 2000-December 2013. Results: A total of 78 patients were analyzed. Sixteen (20%) patients achieved pCR. Estrogen receptor (ER) positivity was lower in pCR+ than pCR-cases (p=0.011). The median NLR values were similar in both arms. The optimum NLR cut-off point for BC patients with PCR+ was 2.33 (AUC:0.544, 95%CI [0.401-0.688], p=0.586) with sensitivity, specificity, positive predictive value and negative predictive value (NPV) of 50%, 51,6%, 21,1%, and 80%, respectively. Conclusions: This study showed no relationship between the pCR and pretreatment NLR values. Because of a considerable high NPV, in the patients with higher NLR who had luminal type BC in which pCR is lower after NACT, such treatment may not be recommended.

참고문헌

  1. Aliustaoglu M, Bilici A, Seker M, et al (2010). The association of pre-treatment peripheral blood markers with survival in patients with pancreatic cancer. Hepatogastroenterology, 57, 640-5.
  2. Azab B, Bhatt V, Phookhan J, et al (2012). Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol, 19, 217-24. https://doi.org/10.1245/s10434-011-1814-0
  3. Cocquyt VF, Blondeel PN, Depypere HT, et al (2003) Different responses to preoperative chemotherapy for invasive lobular and invasive ductal breast carcinoma. Eur J Surg Oncol, 29, 361-67. https://doi.org/10.1053/ejso.2002.1404
  4. Bear HD, Anderson S, Brown A, et al (2003). The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide:preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B- 27. J Clin Oncol, 21, 4165-74. https://doi.org/10.1200/JCO.2003.12.005
  5. Bonadonna G, Veronesi U, Brambilla C, et al (1990). Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or more. J Natl Cancer Inst, 82, 1539-45. https://doi.org/10.1093/jnci/82.19.1539
  6. Buzdar AU, Ibrahim NK, Francis D, et al (2005). Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol, 23, 3676-85. https://doi.org/10.1200/JCO.2005.07.032
  7. Colleoni M, Viale G, Zahrieh D, et al (2004). Chemotherapy is more effective in patients with breast cancer not expressing steroid hormone receptors: a study of preoperative treatment. Clin Cancer Res, 10, 6622-8. https://doi.org/10.1158/1078-0432.CCR-04-0380
  8. Cortazar P, Zhang L, Untch M, et al (2014). Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet, 13, 62422-8.
  9. Coussens LM, Werb Z (2002). Inflammation and cancer. Nature, 420, 860-67. https://doi.org/10.1038/nature01322
  10. Cristofanilli M, Gonzalez-Angulo A, Sneige N, et al (2005). Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol, 23, 41-8. https://doi.org/10.1200/JCO.2005.03.111
  11. Dou X, Wang RB, Yan HJ, et al (2013). Circulating lymphocytes as predictors of sensitivity to preoperative chemoradiotherapy in rectal cancer cases. Asian Pac J Cancer Prev, 14, 3881-5. https://doi.org/10.7314/APJCP.2013.14.6.3881
  12. Hennessy BT, Hortobagyi GN, Rouzier R, et al (2005). Outcome after pathologic complete eradication of cytologically proven breast cancer axillary node metastases following primary chemotherapy. J Clin Oncol, 23, 9304-11. https://doi.org/10.1200/JCO.2005.02.5023
  13. Fisher B, Brown A, Mamounas E, et al (1997). Effect of preopera tive chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol, 15, 2483-93.
  14. Fogar P, Sperti C, Basso D, et al (2006). Decreased total lymphocyte counts in pancreatic cancer: an index of adverse outcome. Pancreas, 32, 22-8. https://doi.org/10.1097/01.mpa.0000188305.90290.50
  15. Fox P, Hudson M, Brown C, et al (2013). Markers of systemic inflammation predict survival in patients with advanced renal cell cancer. Br J Cancer, 109, 147-53. https://doi.org/10.1038/bjc.2013.300
  16. Jung MR, Park YK, Jeong O, et al (2011). Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stagegastric cancer. J Surg Oncol, 104, 504-10. https://doi.org/10.1002/jso.21986
  17. Kaufmann M, von Minckwitz G, Mamounas EP, et al (2012). Recommendations from an international consensus conference on the current status and future of neoadjuvant systemic therapy in primary breast cancer. Ann Surg Oncol, 19, 1508-16. https://doi.org/10.1245/s10434-011-2108-2
  18. Kaya V, Yildirim M, Demirpence O, et al (2013). Prognostic significance of basic laboratory methods in non- small-celllung cancer. Asian Pac J Cancer Prev, 14, 5473-76. https://doi.org/10.7314/APJCP.2013.14.9.5473
  19. Kim KI, Lee KH, Kim TR, et al (2014). Ki-67 as a predictor of response to neoadjuvant chemotherapy in breast cancer patients. J Breast Cancer, 17, 40-6. https://doi.org/10.4048/jbc.2014.17.1.40
  20. Lv M, Li B, Li Y, et al (2011). Predictive role of molecular subtypes in response to neoadjuvant chemotherapy in breast cancer patients in Northeast China. Asian Pac J Cancer Prev, 12, 2411-7.
  21. Rastogi P, Anderson SJ, Bear HD, et al (2008). Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol, 26, 778-85. https://doi.org/10.1200/JCO.2007.15.0235
  22. Noh H, Eomm M, Han A (2013). Usefulness of pretreatment neutrophil to lymphocyte ratio in predicting disease-specific survival in breast cancer patients. J Breast Cancer, 16, 55-9. https://doi.org/10.4048/jbc.2013.16.1.55
  23. Ownby HE, Roi LD, Isenberg RR, et al (1983). Peripheral lymphocyte and eosinophil counts as indicators of prognosis in primary breast cancer. Cancer, 52, 126-30.
  24. Ozdemir Y, Akin ML, Sucullu I, et al (2014). Pretreatment neutrophil/lymphocyte ratio as a prognostic aid in colorectal cancer. Asian Pac J Cancer Prev, 15, 2647-50. https://doi.org/10.7314/APJCP.2014.15.6.2647
  25. Ray-Coquard I, Cropet C, Van Glabbeke M, et al (2009). European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas. Cancer Res, 69, 5383-91. https://doi.org/10.1158/0008-5472.CAN-08-3845
  26. Schmidt H, Suciu S, Punt CJ, et al (2007). Pretreatment levels of peripheral neutrophils and leukocytes as independent predictors of overall survival in patients with American Joint Committee on Cancer Stage IV Melanoma: results of the EORTC 18951 Biochemotherapy Trial. J Clin Oncol, 25, 1562-69. https://doi.org/10.1200/JCO.2006.09.0274
  27. Sinacki M, Badzio A, Welnicka-Jaskiewicz M, et al (2011). Pattern of care in locally advanced breast cancer: focus on local therapy. Breast, 20, 145-50. https://doi.org/10.1016/j.breast.2010.08.008
  28. Strieter RM, Burdick MD, Mestas J, et al (2006). Cancer CXC chemokine networks and tumour angiogenesis. Eur J Cancer, 42, 768-78. https://doi.org/10.1016/j.ejca.2006.01.006
  29. Templeton AJ, Ace O, McNamara MG, et al (2014). Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev, 23, 1204-12. https://doi.org/10.1158/1055-9965.EPI-14-0146
  30. Unal D, Eroglu C, Kurtul N, et al (2013). Are neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? Asian Pac J Cancer Prev, 14, 5237-42. https://doi.org/10.7314/APJCP.2013.14.9.5237

피인용 문헌

  1. Diagnostic and Prognostic Importance of the Neutrophil Lymphocyte Ratio in Breast Cancer vol.15, pp.23, 2015, https://doi.org/10.7314/APJCP.2014.15.23.10363
  2. Preoperative Neutrophil to Lymphocyte Ratio as a Prognostic Factor in Patients with Non-metastatic Renal Cell Carcinoma vol.16, pp.9, 2015, https://doi.org/10.7314/APJCP.2015.16.9.3703
  3. Pretreatment neutrophil-to-lymphocyte ratio is correlated with response to neoadjuvant chemotherapy as an independent prognostic indicator in breast cancer patients: a retrospective study vol.16, pp.1, 2016, https://doi.org/10.1186/s12885-016-2352-8
  4. Mean Platelet Volume as an Independent Predictive Marker for Pathologic Complete Response after Neoadjuvant Chemotherapy in Patients with Locally Advanced Breast Cancer vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.2089
  5. Association of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio with ER and PR in breast cancer patients and their changes after neoadjuvant chemotherapy vol.19, pp.8, 2017, https://doi.org/10.1007/s12094-017-1630-5
  6. The prognostic and predictive value of tumor-infiltrating lymphocytes and hematologic parameters in patients with breast cancer vol.18, pp.1, 2018, https://doi.org/10.1186/s12885-018-4832-5
  7. Prognostic role of high neutrophil-to-lymphocyte ratio in breast cancer patients receiving neoadjuvant chemotherapy vol.98, pp.1, 2019, https://doi.org/10.1097/MD.0000000000013842