Abstract P3-08-67: Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio breast cancer patients according to HER2 overexpression
Authors: Huszno Joanna , Kolosza Zofia , Kwarciak Jolanta Mrochem , Zajusz Aleksander 
Published: March 2020

Abstract
Introduction: HER2 gene amplificationis associated with shorter disease-free and overall survival in breast cancer.The prognostic value of the NLR, PLR, LMR or MLR has been also reported for many types of cancer. The aim of the present study was to assess the blood the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) as a prognostic factors in breast cancer patients (BC) according to HER2 overexpression. Material and Methods: A the retrospective analysis of 529 BC patients who were treated at COI (Gliwice, Poland) between January 2005 and June 2018 was performed. The prognostic value (OS) of the pre-treatment PLR, NLR and MLR was assessed by univariate and multivariate analysis. The cut-off values were determined using receiver operating characteristic curves. Based on the cut-off values determined, the NLR was considered as ‘elevated’ at &gt;1.68, the MLR value was ‘elevated’ at &gt;0.23 and the PLR was considered ‘elevated’ at&gt;119.0. Result: The 5-year OS rates in HER2 positive and HER2 negative BC were 86.5 and 90.4%, respectively.The 5-year OS in the NLR &gt;1.68 subgroup with HER2 (83.0 vs. 93.0%; P=0.579) and without HER2 overexpression (88.7 vs. 92.9%; P=0.159) were lower compared with a patients with NLR &lt;1.68. Similarly, 5-year OS was lower in patients with a PLR of &gt;119.0 with HER2 (85.9vs. 87.8%; P=0.782) and without HER2 overexpression (88.1 vs. 94.0%; P=0.060) compared with that in patients with a PLR of ≤119.0. The 5-year OS was similar in patients with a MLR of &gt;0.23 with HER2 overexpression compared with that in patients with a MLR of ≤119.0 (86.1 vs. 86.7%; P=0.745). In group with a MLR of &gt;0.23 without HER2 overexpression OS was lower compared with that in patients with a MLR of ≤0.23 (89.5 vs. 91.7%; P=0.185). Univariate Cox regression analyses of OS showed that in subgroup with HER2 overexpression factors such as tumor size (T3-4 vs. T1-2, HR=2.47; P=0.008), the presence of lymph node metastases (N+ vs.N0, HR=3.15; P=0.006) and estrogen receptor status (ER(+) vs. ER(-), HR=0.50; P=0.039) were statistically significant. Factors such as NLR, PLR and MLR were not statistically significant.Multivariate analysis revealed that in group breast cancer patients with HER2 overexpression negative prognostic factors were: tumor size and lymph node metastases. In contrary, positive prognostic factor was positive steroid receptor status (ER+).Univariate Cox regression analyses of OS showed that in subgroup without HER2 overexpression factors such as tumor size (T3-4 vs. T1-2, HR=3.89; P=0.0001), the presence of lymph node metastases (N+ vs.N0, HR=3.16; P=0.001), tumor grade (G3 vs. G1-2, HR=2.59; P=0.005), estrogen receptor status (ER(+) vs. ER(-), HR=0.43; P=0.012), progesterone receptor status (PR(+) vs. PR(-), HR=0.31; P=0.001), leukocytes &gt;6.22 (HR=2.11; P=0.041), monocytes &gt;0.52 (HR=2.24; P=0.018) and PLT&gt;291 (HR=2.24; P=0.024) were statistically significant. Factors such as NLR (HR=1.66; P=0.166), PLR (HR=2.03; P=0.067) and MLR (HR=1.61; P=0.192) were not statistically significant. Multivariate analysis revealed that significant negative prognostic factors in without HER2 overexpression breast cancer patients were: tumor size, lymph node metastases and leukocyte number. In contrary, positive prognostic factor were positive steroid receptor status (PR+) and lymphocytes number. Conclusion: Elevated PLR, NLR and MLR worsens insignificantly prognosis in group of patients with tumors without HER2 overexpression. The presence of elevated MLR, PLR, NLR did not influence overall survival (prognosis) in group with HER2 overexpression. In both subgroups (HER2 positive and HER2 negative) common negative prognostic factors were tumor size and lymph node metastases.
Citation Format: Joanna Huszno, Zofia Kolosza, Jolanta Mrochem Kwarciak, Aleksander Zajusz. Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio breast cancer patients according to HER2 overexpression [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-08-67.