Abstract
BackgroundThe relationship of neutrophil/lymphocyte ratio (NLR) to prognosis of HER2-positive breast cancer (BC) is not well studied. We aimed to assess the prognostic role of NLR in HER2-positive BC patients treated with or without trastuzumab.MethodsThe clinical data of 843 HER2-positive BC patients from July 2013 to July 2018 were collected. The difference among variables was calculated by chi-square test. The associations between clinicopathological factors, NLR and disease-free survival (DFS) were analyzed by univariate and multivariate analyses.ResultsPatients were divided into three groups. In group 1 containing 255 patients without trastuzumab treatment, pretreatment NLR showed no predictive value. Patients with trastuzumab treatment were divided into two groups on equal, according to pretreatment NLR values, low NLR (group 2) and high NLR (group 3). Patients in group 2 showed significantly higher 3-year DFS rate than patients in group 1 and group 3 (95.3% vs. 91.6% vs. 90.5%, respectively, P = 0.011); patients in the group 1 and group 3 had a similar 3-year DFS outcome. Multivariate analysis showed high pretreatment NLR was significantly associated with shorter DFS (HR = 2.917, 95% CI = 1.055–8.062, P = 0.039) in HER2-positive BC patients treated with trastuzumab.ConclusionsAmong HER2-positive trastuzumab-treated BC patients, low pretreatment NLR value was associated with better DFS, and it might help to differentiate potential beneficiaries of trastuzumab treatment.
Highlights
The relationship of neutrophil/lymphocyte ratio (NLR) to prognosis of HER2-positive breast cancer (BC) is not well studied
Some studies indicated that low pretreatment neutrophil/lymphocyte ratio (NLR) was predictive factor of better disease-free survival (DFS) outcome in BC, especially in triplenegative BC patients [10,11,12]
In the HER2-positive BC treated with trastuzumab, trastuzumab-induced antibody-dependent cell-mediated cytotoxicity (ADCC) should be taken into consideration for its contribution to the improved DFS outcome when compared with those without trastuzumab treatment [25]
Summary
The relationship of neutrophil/lymphocyte ratio (NLR) to prognosis of HER2-positive breast cancer (BC) is not well studied. HER2, which is associated with aggressive tumor growth and poor prognosis, is over-expressed in 20–25% of all invasive breast cancer (BC). Many studies have found that inflammation and immunity play critical roles in tumor initiation, invasion, and metastasis [6]. Some studies indicated that low pretreatment neutrophil/lymphocyte ratio (NLR) was predictive factor of better DFS outcome in BC, especially in triplenegative BC patients [10,11,12]. In the HER2-positive subtype, few studies have explored the relationship between NLR and DFS of patients with or without trastuzumab treatment. We retrospectively analyzed the NLR as the predictive factor of 843 HER2-positive BC patients with or without trastuzumab treatment
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