Prognostic value of the neutrophil‑lymphocyte, platelet‑lymphocyte and monocyte‑lymphocyte ratio in breast cancer patients
- Joanna Huszno
- Zofia Kolosza
Published online on: October 8, 2019
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The aim of the present study was to assess the blood the neutrophil‑lymphocyte ratio (NLR), platelet‑lymphocyte ratio (PLR) and monocyte‑lymphocyte ratio (MLR) as prognostic factors in breast cancer (BC) patients. A retrospective analysis of 436 BC patients who were treated at COI (Gliwice, Poland) between January 2005 and June 2018 was performed. The prognostic value [overall survival (OS)] of the pre‑treatment PLR, NLR and MLR was assessed by univariate and multivariate analysis. The 5‑year OS was lower in the NLR >2.65 compared with that in the NLR≤2.65 group (82.5 vs. 89.6%; P=0.053), and significantly lower in the subgroup of triple‑negative breast cancer (TNBC; 70.3 vs. 89.3%; P=0.034) and in patients whose tumors had an estrogen receptor‑negative [ER(‑)] status (66.6 vs. 83.6%; P=0.018). The 5‑year OS was lower in patients with PLR >190.9 compared with that in the PLR≤190.9 group (78.7 vs. 89.4%; P=0.020). A poor OS rate associated with an elevated PLR was also observed in the subgroups with TNBC (68.2 vs. 88.5%; P=0.032) and with ER(‑) status tumors (57.7 vs. 83.6%, P=0.002). An elevated MLR (>0.28) was not associated with OS time (P=0.830). Multivariate analysis revealed that the NLR and PLR were insignificant negative prognostic factors, except for the subgroup of patients with ER(‑) tumors, where an elevated NLR [hazard ratio (HR)=2.40; 95% confidence interval (CI): 1.20‑4.80; P=0.013] and a higher PLR (HR=2.51; 95%CI: 1.23‑5.14; P=0.012) were independent prognostic factors for poor OS together with lymph node metastasis ((HR=5.47; 95%CI: 2.46‑12.15; P=0.0001 and HR=4.82; 95% CI: 2.15‑10.78; P=0.0001), respectively. The present results revealed that an elevated NLR (>2.65) and PLR (>190.9) are associated with poor OS in BC patients. In the ER(‑) subgroup of patients, an elevated NLR and PLR were significant independent prognostic factors. However, the MLR did not affect OS.