A high neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are associated with a worse outcome in inflammatory breast cancer. (October 2020)

• Record Type: Journal Article
• Authors: Van Berckelaer, C.; Van Geyt, M.; Linders, S.; Rypens, C.; Trinh, X.B.; Tjalma, W.A.A.; Van Laere, S.; Colpaert, C.; Dirix, L.; van Dam, P.A.
• Is Part Of: Breast. Volume 53(2020)
• Page Start: 212
• Page End: 220
• Publication Date: 2020-10
• Subjects: Inflammatory breast cancer (IBC) -- Neutrophil-to-lymphocyte ratio (NLR) -- Platelet-lymphocyte ratio (PLR) -- Lymphocyte-monocyte ratio (LMR) -- Stromal tumor infiltrating lymphocytes (sTIL) -- Immune response; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2020.08.006
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Introduction: Inflammatory breast cancer (IBC) is an uncommon, but aggressive form of breast cancer that accounts for a disproportionally high fraction of breast cancer related mortality. The aim of this study was to explore the peripheral immune response and the prognostic value of blood-based biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), in a large IBC cohort. Patients & methods: We retrospectively identified 127 IBC patients and collected lab results from in-hospital medical records. The differential count of leukocytes was determined at the moment of diagnosis, before any therapeutic intervention. A cohort of early stage (n = 108), locally advanced (n = 74) and metastatic breast cancer patients (n = 41) served as a control population. Results: The NLR was significantly higher in IBC compared to an early stage breast cancer cohort, but no difference between IBC patients and locally advanced breast cancer patients was noted. In the metastatic setting, there was also no significant difference between IBC and nIBC. However, a high NLR (>4.0) remained a significant predictor of worse outcome in IBC patients (HR: 0.49; 95% CI: 0.24–1.00; P = .05) and a lower platelet-lymphocyte ratio (PLR) (≤210) correlated with a better disease-free survival (DFS) (HR: 0.51; 95% CI: 0.28–0.93; P = .03). Conclusion: Patients with a high NLR (>4.0) have a worse overall prognosis in IBC, while the PLR correlated with relapse free survival (RFS). Since NLR and PLR were not specifically associated with IBC disease, they can be seen as markers of more extensive disease. Highlights: There is no association between NLR or PLR and inflammatory breast cancer (IBC). IBC and non-inflammatory breast cancer elicit a similar peripheral immune response. A high neutrophil-to-lymphocyte ratio (NLR) is associated with a worse overall survival in IBC. A high platelet-lymphocyte ratio (PLR) correlates with a worse disease-free survival in IBC. An elevated PLR or NLR should be seen as a marker of more extensive disease in IBC.