Abstract
PurposeThe objective of this study was to explore the prognostic significance of pretreatment hematologic parameters in predicting disease-free survival (DFS) of breast cancer patients.Materials and MethodsThe medical records of 440 breast cancer patients in Shandong Cancer Hospital and Institute from 2003 to 2013 were analyzed retrospectively. Through the results of blood routine before treatment, the absolute lymphocyte count (ALC), absolute neutrophil count (ANC), absolute monocyte count (AMC), and absolute platelet count (APC) in peripheral blood were collected. The lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-monocyte ratio (NMR) were calculated. Cox proportional hazard model was used for univariate and multivariate analysis. The DFS was compared using Kaplan–Meier method. The prognostic nomogram of patients with breast cancer was developed.ResultsThe median DFS for all patients was 64.10 months. Univariate analysis showed that the DFS was associated with surgical approach, TNM stage, molecular subtype, neoadjuvant chemotherapy, radiotherapy, and LMR (p < 0.05). TNM stage, molecular subtype, and LMR were independent prognostic factors of breast cancer in multivariate analysis (p < 0.05). According to the Kaplan–Meier survival curve analysis, patients with higher LMR (≥4.85) were associated with longer median DFS (median DFS, 85.83 vs. 60.90, p < 0.001). The proposed nomogram that incorporated LMR, TNM stage, and molecular subtype got a concordance index (c-index) of 0.69 in predicting 5-year DFS.ConclusionIn breast cancer patients, higher LMR was associated with longer median DFS and the nomogram including LMR, TNM stage, and molecular subtype could accurately predict the prolonged 5-year DFS of breast cancer patients.
Highlights
Breast cancer is the most common cancer in women; patients in China account for 12.2% of all newly diagnosed breast cancers and 9.6% of all deaths from breast cancer around the world [1]
Pathological indicators such as tumor size, axillary lymph node metastasis, and histological grade, as well as molecular biological indicators such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), and ki67 are currently used to guide the prognosis of breast cancer patients [4]
This study comprehensively evaluated the predictive value of eight hematological parameters for disease-free survival (DFS) in breast cancer patients and found that only lymphocyte-tomonocyte ratio (LMR) was related to DFS, and the high LMR group had longer DFS
Summary
Breast cancer is the most common cancer in women; patients in China account for 12.2% of all newly diagnosed breast cancers and 9.6% of all deaths from breast cancer around the world [1]. It is important to screen patients with higher recurrence and metastasis early for individualized treatment of breast cancer Pathological indicators such as tumor size, axillary lymph node metastasis, and histological grade, as well as molecular biological indicators such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), and ki are currently used to guide the prognosis of breast cancer patients [4]. These indicators mainly obtained by biopsy or postoperative pathological reports are difficult to represent the overall condition of the tumor. No evidences showed the prognostic values of systematic hematological parameters and clinical information in breast cancer
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