Neutrophil Lymphocyte Ratio In Breast Cancer: Prognostic Value

Document Type : Original Article

Authors

1 National Cancer Institute-University of Gezira (NCI-UG), Sudan.

2 Department of Physiology, Faculty of Medicine, Al-Baha University, KSA.

Abstract

Introduction: Breast cancer (BC) is a common female cancer worldwide including in Sudan. Despite the improvement in diagnosis, still more effort is needed for prognostic biomarkers. Objectives: To assess the predictive value of neutrophils-lymphocytes ratio (NLR) in BC disease-free survival (DFS) and overall survival (OS). Method: This was a retrospective hospital-based study including 65 stage-III BC female patients treated at the National Cancer Institute -University of Gezira (NCI-UG), Sudan between 1st January 2013 and 31st December 2014 and followed up to 2019. Data were retrieved from medical records and SPSS software was used for statistical analysis. X2 test was used to demonstrate the association of NLR with demographic, clinicopathological and therapeutic variables. Cox regression models were used to determine the hazard ratios and 95% confidence intervals (CIs) of DFS and OS in relation to pre-treatment NLR. Results: Analysis showed that patients with high NLR had a high rate of postoperative recurrence and death. From the 65 investigated BC patients, 20 (31%) have abnormally higher than normal NLR (> 3%). Of those 31% BC patients, 70% were in the age group > 40 years old, 75% were histologically grade III, 95% were invasive ductal carcinoma (IDC) histological type, 55% were postmenopausal, 89.5% were lymph node-positive, and 70% not underwent radiotherapy. NLR was identified as an independent prognostic factor for DFS and OS in stage III BC (P < 0.05). Conclusion: It had been concluded that high NLR was associated with decreased DFS and OS and a higher rate of postoperative recurrence and death in BC.

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