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Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting

1
Center for Advanced Studies and Technology (CAST), Department of Innovative Technologies in Medicine & Dentistry, G. D’Annunzio University, 66100 Chieti, Italy
2
Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, UK
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Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
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Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
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Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University, 00185 Rome, Italy
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Center for Advanced Studies and Technology (CAST), Department of Medical, Oral and Biotechnological Sciences, G. D’Annunzio University, 66100 Chieti, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Jadwiga Jabłońska
Cells 2021, 10(7), 1685; https://doi.org/10.3390/cells10071685
Received: 7 May 2021 / Revised: 23 June 2021 / Accepted: 28 June 2021 / Published: 3 July 2021
(This article belongs to the Special Issue The Role of Neutrophils in Cancer)
The neutrophil to lymphocyte ratio (NLR) is a promising predictive and prognostic factor in breast cancer. We investigated its ability to predict disease-free survival (DFS) and overall survival (OS) in patients with luminal A- or luminal B-HER2-negative breast cancer who received neoadjuvant chemotherapy (NACT). Pre-treatment complete blood cell counts from 168 consecutive patients with luminal breast cancer were evaluated to assess NLR. The study population was stratified into NLRlow or NLRhigh according to a cut-off value established by receiving operator curve (ROC) analysis. Data on additional pre- and post-treatment clinical-pathological characteristics were also collected. Kaplan–Meier curves, log-rank tests, and Cox proportional hazards models were used for statistical analyses. Patients with pre-treatment NLRlow showed a significantly shorter DFS (HR: 6.97, 95% CI: 1.65–10.55, p = 0.002) and OS (HR: 7.79, 95% CI: 1.25–15.07, p = 0.021) compared to those with NLRhigh. Non-ductal histology, luminal B subtype, and post-treatment Ki67 ≥ 14% were also associated with worse DFS (p = 0.016, p = 0.002, and p = 0.001, respectively). In a multivariate analysis, luminal B subtype, post-treatment Ki67 ≥ 14%, and NLRlow remained independent prognostic factors for DFS, while only post-treatment Ki67 ≥ 14% and NLRlow affected OS. The present study provides evidence that pre-treatment NLRlow helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT. View Full-Text
Keywords: luminal breast cancer; neoadjuvant chemotherapy; neutrophil to lymphocyte ratio (NLR); predictive/prognostic biomarkers luminal breast cancer; neoadjuvant chemotherapy; neutrophil to lymphocyte ratio (NLR); predictive/prognostic biomarkers
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MDPI and ACS Style

Grassadonia, A.; Graziano, V.; Iezzi, L.; Vici, P.; Barba, M.; Pizzuti, L.; Cicero, G.; Krasniqi, E.; Mazzotta, M.; Marinelli, D.; Amodio, A.; Natoli, C.; Tinari, N. Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting. Cells 2021, 10, 1685. https://doi.org/10.3390/cells10071685

AMA Style

Grassadonia A, Graziano V, Iezzi L, Vici P, Barba M, Pizzuti L, Cicero G, Krasniqi E, Mazzotta M, Marinelli D, Amodio A, Natoli C, Tinari N. Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting. Cells. 2021; 10(7):1685. https://doi.org/10.3390/cells10071685

Chicago/Turabian Style

Grassadonia, Antonino, Vincenzo Graziano, Laura Iezzi, Patrizia Vici, Maddalena Barba, Laura Pizzuti, Giuseppe Cicero, Eriseld Krasniqi, Marco Mazzotta, Daniele Marinelli, Antonella Amodio, Clara Natoli, and Nicola Tinari. 2021. "Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting" Cells 10, no. 7: 1685. https://doi.org/10.3390/cells10071685

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