Abstract
PurposeAmong patients with breast cancer, pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) is an important prognostic predictor of survival. This study aimed to investigate the relationship between platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) along with overall pCR.MethodA total of 150 patients with breast cancer who were first administered NAC and then operated on were retrospectively evaluated. Neutrophil-lymphocyte ratio and PLR obtained from the complete blood count analysis performed immediately before NAC treatment were analyzed. The cut-off value was calculated as 150 for PLR and 2.24 for NLR. We studied the predictive value of NLR and PLR levels for the pathologic response of breast cancer to NAC.ResultsPathological complete response was observed in 34.7% (n = 52) of the patients, pCR in the breast in 42.7% (n = 64), and that in the axilla in 44% (n = 66). There was a statistically significant difference between the pCR rates according to the PLR levels (p = 0.013). In addition, a statistically significant difference was found in the pCR rates in the breast and axilla according to PLR levels (p = 0.018, p = 0.009). Patients with low PLR in the human epidermal growth factor receptor 2 (HER-2) group had significantly higher axillary pCR rates than in those with high PLR (p = 0.019).ConclusionsA low PLR level showed high chemotherapy sensitivity independent of molecular subtypes in the treatment of breast cancer with NAC. The PLR level can serve as a predictive marker of the therapeutic effect of NAC on the breast and axilla. Low PLR levels in HER-2 enriched groups can predict pCR in the axilla.
Highlights
In recent years, the use of neoadjuvant chemotherapy (NAC) has increased in the treatment of breast cancer
This study aimed to investigate the relationship between platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) along with overall pathological complete response (pCR)
We studied the predictive value of NLR and PLR levels for the pathologic response of breast cancer to NAC
Summary
The use of neoadjuvant chemotherapy (NAC) has increased in the treatment of breast cancer. The risk of both locoregional and distant metastases is reduced with subtypes-specific systemic treatments performed before surgery. NAC provides de-escalating surgery in the breast and the axilla that pathological complete response (pCR) is achieved in some patients. Pathological complete response is an effective factor in predicting overall survival and disease-free survival which are generally improved (increased) after complete response to chemotherapy. Neutrophils act on the elements of the complement system and the adaptive immune system, thereby strengthening the inflammatory response [5,6,7,8]. Platelets can be involved in the inflammatory response by increasing angiogenesis or by providing growth factor
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