Prognostic value of lymphocyte-related systemic inflammatory biomarkers in triple negative breast cancer. Original article
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Published:
Sep 8, 2022
Keywords:
triple negative breast cancer, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, the systemic immune inflammation index, prognostic factor
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Abstract
The aim was to evaluate inflammatory biomarkers as prognostic factors in patients with triple negativbreast cancer. We have collected data from 143 patients and evaluated using Chi-Squared test, Wilcoxon–Mann–Whitney test and Cox regression. We found a relationship between high neutrophil- to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index and local advancement features: tumor (T3/T4) (P = 0.0001, P = 0.0198, P = 0.0001), positive regional lymph nodes (P = 0.0014, P = 0.0075, P = 0.0206). In the multivariate analysis metastatic disease, worse performance status and high NLR (Hazard ratio: 4.48 [2.05–9.80], P=0.0002; 2.23 [1.24–4.03], P=0.0010; 2.23 [1.24–4.03], P=0.0075) were adverse prognostic factors. High neutrophil-to-lymphocyte ratio with worse performance status turned out an adverse independent prognostic factors.
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1.
Oraczewski R, Czerniawska-Meler M, Korzeniewicz M, Kade G, Kozielec Z, Michalak M, Król M, Zdaniukiewicz A, Bodnar L. Prognostic value of lymphocyte-related systemic inflammatory biomarkers in triple negative breast cancer. OncoReview [Internet]. 2022Sep.8 [cited 2024Apr.16];12(2(46):25-4. Available from: https://journalsmededu.pl/index.php/OncoReview/article/view/1800
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CARDIO-ONCOLOGY
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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36. Salgado R, Denkert C, Demaria S et al. The evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer: recommendations by an International TILs Working Group 2014. Ann Oncol. 2015; 26(2): 259-71.
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39. Yoon CI, Park S, Cha YJ et al. Associations between absolute neutrophil count and lymphocyte-predominant breast cancer. The Breast. 2020; 50: 141-8.
2. Sung H, Ferlay J, Siegel RL et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3): 209-49.
3. Boyle P. Triple-negative breast cancer: epidemiological considerations and recommendations. Ann Oncol. 2012; 23: vi7-12.
4. Bianchini G, Balko JM, Mayer IA et al. Triple-negative breast cancer: challenges and opportunities of a heterogeneous disease. Nat Rev Clin Oncol. 2016; 13(11): 674-90.
5. Kaul K, Misri S, Ramaswamy B et al. Contribution of the tumor and obese microenvironment to triple negative breast cancer. Cancer Lett. 2021; 509: 115-20.
6. Wang Z, Aguilar EG, Luna JI et al. Paradoxical effects of obesity on T cell function during tumor progression and PD-1 checkpoint blockade. Nat Med. 2019; 25(1): 141-51.
7. Tiwari P, Blank A, Cui C et al. Metabolically activated adipose tissue macrophages link obesity to triple-negative breast cancer. J Exp Med. 2019; 216(6): 1345-58.
8. Springer NL, Iyengar NM, Bareja R et al. Obesity-Associated Extracellular Matrix Remodeling Promotes a Macrophage Phenotype Similar to Tumor-Associated Macrophages. Am J Pathol. 2019; 189(10): 2019-35.
9. Huszno J, Kolosza Z. Prognostic value of the neutrophil‑lymphocyte, platelet‑lymphocyte and monocyte‑lymphocyte ratio in breast cancer patients. Oncol Lett. 2019; 18(6): 6275-83
10. Crusz SM, Balkwill FR. Inflammation and cancer: advances and new agents. Nat Rev Clin Oncol. 2015; 12(10): 584-96.
11. Semeniuk-Wojtaś A, Lubas A, Stec R et al. Neutrophil-to-lymphocyte Ratio, Platelet-to-lymphocyte Ratio, and C-reactive Protein as New and Simple Prognostic Factors in Patients With Metastatic Renal Cell Cancer Treated With Tyrosine Kinase Inhibitors: A Systemic Review and Meta-analysis. Clin Genitourin Cancer. 2018; 16(3): e685-93.
12. Templeton AJ, McNamara MG, Šeruga B et al. Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Solid Tumors: A Systematic Review and Meta-Analysis. J Natl Cancer Inst. 2014; 106(6): dju124.
13. Chrom P, Stec R, Bodnar L, Szczylik C. Incorporating Neutrophil-to-lymphocyte Ratio and Platelet-to lymphocyte Ratio in Place of Neutrophil Count and Platelet Count Improves Prognostic Accuracy of the International Metastatic Renal Cell Carcinoma Database Consortium Model. Cancer Res Treat. 2018; 50(1): 103-10.
14. Polley MYC, Leon-Ferre RA, Leung S et al. A clinical calculator to predict disease outcomes in women with triple-negative breast cancer. Breast Cancer Res Treat. 2021; 185(3): 557-66.
15. Corbeau I, Thezenas S, Maran-Gonzalez A et al. Inflammatory Blood Markers as Prognostic and Predictive Factors in Early Breast Cancer Patients Receiving Neoadjuvant Chemotherapy. Cancers. 2020; 12(9): 2666.
16. WHO Expert Committee on Physical Status: the Use and Interpretation of Anthropometry ( 1993 : Geneva, Switzerland) & World Health Organization. (1995) . Physical status : the use of and interpretation of anthropometry , report of a WHO expert committee. World Health Organization, 1995.
17. Guo W, Lu X, Liu Q et al. Prognostic value of neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio for breast cancer patients: An updated meta‐analysis of 17079 individuals. Cancer Med. 2019; 8(9): 4135-48.
18. Zhang Y, Sun Y, Zhang Q. Prognostic value of the systemic immune-inflammation index in patients with breast cancer: a meta-analysis. Cancer Cell Int. 2020; 20(1): 224.
19. Escudier B, Porta C, Schmidinger M et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019; 30(5): 706-20.
20. Guner A, Kim HI. Biomarkers for Evaluating the Inflammation Status in Patients with Cancer. J Gastric Cancer. 2019; 19(3): 254.
21. Xuan Q, Yang Y, Ji H et al. Combination of the preoperative albumin to globulin ratio and neutrophil to lymphocyte ratio as a novel prognostic factor in patients with triple negative breast cancer. Cancer Manag Res. 2019; 11: 5125-31.
22. Liu J, Shi Z, Bai Y et al. Prognostic significance of systemic immune-inflammation index in triple-negative breast cancer. Cancer Manag Res. 2019; 11: 4471-80.
23. Lovejoy JC, de la Bretonne JA, Klemperer M et al. Abdominal fat distribution and metabolic risk factors: Effects of race. Metabolism. 1996; 45(9): 1119-24.
24. Furuncuo Y, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016; 20(7): 1300-6.
25. Jiang C, Lu Y, Zhang S et al. Systemic Immune-Inflammation Index Is Superior to Neutrophil to Lymphocyte Ratio in Prognostic Assessment of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy. Biomed Res Int. 2020; 2020: 7961568.
26. Wang Y, Zhang X, Xie X et al. Obesity and metabolic syndrome related macrophage promotes PD-L1 expression in TNBC through IL6/JAK/STAT pathway and can be reversed by telmisartan. Cancer Biol Ther. 2020; 21(12): 1179-90.
27. Al Jarroudi O, Abda N, Seddik Y et al. Overweight: Is It a Prognostic Factor in Women with Triple-Negative Breast Cancer? Asian Pac J Cancer Prev. 2017; 18(6): 1519-23.
28. Mowad R, Chu QD, Li BDL et al. Does obesity have an effect on outcomes in triple-negative breast cancer? J Surg Res. 2013; 184(1): 253-9.
29. Borges TC, Gomes TLN, Pichard C et al. High neutrophil to lymphocytes ratio is associated with sarcopenia risk in hospitalized cancer patients. Clin Nutr. 2021; 40(1): 202-6.
30. Fang Q, Tong YW, Wang G et al. Neutrophil-to-lymphocyte ratio, obesity, and breast cancer risk in Chinese population. Medicine (Baltimore). 2018; 97(30): e11692.
31. Launay-Vacher V, Janus N, Deray G. Renal insufficiency and cancer treatments. ESMO Open. 2016; 1(4): e000091.
32. Launay-Vacher V, Oudard S, Janus N et al. Prevalence of Renal Insufficiency in cancer patients and implications for anticancer drug management: The renal insufficiency and anticancer medications (IRMA) study. Cancer. 2007; 110(6): 1376-84.
33. The Renal Insufficiency and Anticancer Medications (IRMA) Study Group; Launay-Vacher V, Gligorov J et al. Prevalence of renal insufficiency in breast cancer patients and related pharmacological issues. Breast Cancer Res Treat. 2010; 124(3): 745-53.
34. Launay-Vacher V, Janus N, Spano J et al. Impact of renal insufficiency on cancer survival: Results of the IRMA 2 study. J Clin Oncol. 2009; 27(15_suppl): 9585.
35. Basu A, Ramamoorthi G, Jia Y et al. Immunotherapy in breast cancer: Current status and future directions. Adv Cancer Res. 2019; 143: 295-349.
36. Salgado R, Denkert C, Demaria S et al. The evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer: recommendations by an International TILs Working Group 2014. Ann Oncol. 2015; 26(2): 259-71.
37. Hubalek M, Czech T, Müller H. Biological Subtypes of Triple-Negative Breast Cancer. Breast Care. 2017;12(1): 8-14.
38. Lee KH, Kim EY, Yun JS et al. The prognostic and predictive value of tumor-infiltrating lymphocytes and hematologic parameters in patients with breast cancer. BMC Cancer. 2018; 18(1): 938.
39. Yoon CI, Park S, Cha YJ et al. Associations between absolute neutrophil count and lymphocyte-predominant breast cancer. The Breast. 2020; 50: 141-8.