Abstract
Red cell distribution width (RDW) to platelet ratio (RPR) is a prognosticator in acute pancreatitis and myocardial infarction; however, the prognostic values of RDW and RPR in breast cancer have not been studied. This retrospective analysis of 299 breast cancer patients investigated the association between RDW and RPR and clinicopathological characteristics and prognosis, compared to platelet distribution width to platelet count ratio (PDW/P) which is a known independent prognostic factor in patients with breast cancer. We found a significant correlation between RPR, and age and HER2 status. An elevated RPR significantly correlated with age and HER2 status. After a median follow-up duration of 48 months, tumour size, nuclear grade, PDW/P, and RPR were recgnized to be significantly associated with lower disease-free survival rates (tumour size: p < 0.01; nuclear grade, PDW/P, and RPR: p < 0.05) in univariate analysis. Tumour size and RPR were significant prognostic factors for lower disease-free survival rates, with hazard ratios of 4.31 (95% confidence interval: 1.76–10.53) (p < 0.01)] and 2.79 [95% confidence interval: 1.01–87.69) (p < 0.05)], respectively, in a multivariate analysis using the Cox proportional hazards model. This is the first study showing that an elevated RPR could independently predict poor prognosis in patients with breast carcinoma. Thus, RPR could be a novel biomarker for prognostic estimation.
Highlights
Breast cancer is the most common malignant disease among women in Japan[1]
With regards to PDW/P, Red blood cell distribution width (RDW), and RDW to platelet count ratio (RPR), patients were divided into two groups according to the optimised cut-off values determined by receiver operating characteristic (ROC) analysis
ROC analysis showed that the optimal cut-off values for disease-free survival (DFS) were 0.59, 13.7 and 0.71 for the PDW/P, RDW and RPR, respectively (Table 2)
Summary
Breast cancer is the most common malignant disease among women in Japan[1]. For patients with breast cancer, prognostic estimation is crucial because it greatly impacts the selection of the most appropriate treatment. There could be an urgent need to establish simple and low-cost prognostic biomarkers for breast cancer using routine haematological parameters of the complete blood count. To the best of our knowledge, no studies regarding the prognostic values of RDW and RPR in patients with breast cancer have been conducted. Www.nature.com/scientificreports platelet count ratio (PDW/P) was a significant prognostic factor in patients with breast cancer[13]. The purpose of the present study was to investigate the prognostic value of the RDW and RPR in breast cancer patients, compared with PDW/P
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