Abstract P6-07-40: Initial Neutrophil-to-Lymphocyte ratio in primary breast cancer patients: a simple and useful biomarker as prognostic factor

Abstract

Abstract Background: Increasing neutrophil/lymphocyte ratios (NLR) on preoperative blood tests have been associated with worse survival of patients with colorectal, gastric, hepatocellular, pancreatic and lung cancer. However the utility of NLR to predict mortality in breast cancer patients has not been studied. The aim of our study was to determine whether the NLR is predictive of disease specific mortality in breast cancer and subtype-adjusted prognostic effect in breast cancer patients. Methods: We retrospectively identified all the patients with primary breast cancer diagnosed at Yonsei University Wonju Medical School between January 2000 and June 2011 who underwent primary surgery and completed all phase of their treatment. Breast cancer with infiltrating ductal histology was included and divided into 4 subtypes: Luminal A, Luminal B, Her2-enriched, and basal type. Each immunohistochemical characteristics are as followings: Luminal A: ER and/or PgR positive and negative Her2, Luminal B: ER and/or PgR positive with positive HER2, Her2-enriched: negative ER and PR with positive Her2, and triple negative as basal. Results: Patients with NLR≥2.5 showed significantly lower 5-year, 10-year breast cancer specific survival than patients with NLR<2.5. (5-year survival; 88.6% vs. 96.4%, p = 0.009, 10-year survival; 84.3% vs. 92.2%, p = 0.006). Cox proportional multivariate hazard model for cancer-specific mortality showed that patients with NLR≥2.5 has hazard ratio 4.71 with 95% confidence interval 1.77–12.53. Further analysis was done according to stratified patients' subgroup with intrinsic subtype. In Luminal A subtype, patients with NLR≥2.5 showed higher mortality rate(p = 0.014), while NLR≥2.5 failed to show statistical significance in the other subtype such as Luminal B, Her2 enriched, and triple negative subtype. Conclusion: Increased preoperative NLR is a significant prognostic factor in breast cancer specific survival and relevant in Luminal A subtype. This study shows that NLR could be a useful prognostic factor for breast cancer specific survival. And this study suggests that different factors could contribute as prognostic factor to each subtype, such as NLR was significant prognostic factor in Luminal A, while we couldn't find increased NLR is significant in other subtypes. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-07-40.