Abstract P2-08-49: The role of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) andmonocyte – lymphocyte ratio (MLR) in prognosis of breast cancer patients
Authors: Huszno J , Kołosza Z , Mrochem Kwarciak J , Rutkowski T , Składowski K 
Published: May 2019

Abstract
Introduction: Breast cancer (BC) is common malignancies in women.Biomarkers such as neutrophils, lymphocyte, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), monocyte – lymphocyte ratio (MLR) and PLT have been demonstrated to be closely related to poor prognosis in several solid tumors. The objective of this study was to evaluate the blood PLR, NLR andMLR for its prognostic value in patients with breast cancer.Material and Methods: We retrospectively reviewed 436 breast cancer patients (all woman) diagnosed and treated in MSC Memorial Cancer and Institute of Oncology, Gliwice Branch in years 2005 - 2018. The median age of patients was 52.5 years (range from 25 to 78). We assessed the prognostic value (overall survival) of pretreatment PLR, NLR and MLRbased on univariate and multivariate analysis. The cut-off value of NLR was 'elevated' as &gt;2.65, MLR value was 'elevated'as &gt;0.28 and PLR cut-off value was 'elevated' as &gt;190.9.Results: Median follow-up was 71 months (range, from 3 to 165 months). The 5-year and 10-year OS rates were 88.1% and 80.2%, respectively. The 5-year OS was lower in NLR &gt; 2.65 in comparison to NLR&lt;=2.65 (82.5% vs.89.6%, p=0.053), especially in subgroup of triple negative breast cancer (TNBC) (70.3% vs. 89.3%, p=0.034) and in patients with estrogen receptor negative status tumors (66.6% vs. 83.6%, p=0.018).Similarly, the 5-year OS was lower in patients with PLR &gt; 190.9 in comparison to PLR&lt;=190.9 (78.7% vs. 89.4%; p=0.020). The worse OS rate was also observed in subgroup with TNBC and PLR &gt; 190.9 (68.2% vs. 88.5%, p=0.032) or in subgroup with ER negative steroid receptor status tumors with 'elevated' PLR (57.7% vs. 83.6%, p=0.002).The 'elevated' value of MLR (&gt;0.28) was not associated with overall survival time in our group of patients (p=0.830), also in TNBC (p=0.219) and ER (-) (p=0.453) subgroups of patients. Multivariate analysis has showed that NLR and PLR were insignificantly negative prognostic factors in all analyzed group. However the analysis in subgroup of patients with ER (-) negative tumors has showed that higher NLR (p=0.013; HR=2.40; 95%CI 1.20-4.80) and higher PLR (p=0.012; HR=2.51; 95%CI 1.23-5.14) were an independent factors for lower OS together with metastatic lymph nodes (p=0.0001). Conclusion: Elevated pre-treatment NLR (&gt;2.65) and PLR (&gt;190.9) are associated with lower OS in breast cancer patients. In ER (-) subgroups of patients elevated NLR and PLR were significant independent prognostic factors. MLR did not affect overall survival.
Citation Format: Huszno J, Kołosza Z, Mrochem Kwarciak J, Rutkowski T, Składowski K. The role of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) andmonocyte – lymphocyte ratio (MLR) in prognosis of breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-49.