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Erschienen in: Indian Journal of Surgical Oncology 3/2019

15.06.2019 | Original Article

Elevated Neutrophil–Lymphocyte Ratio in Luminal-Type Locally Advanced Breast Cancer to Circumvent Neo-Adjuvant Chemotherapy

verfasst von: Joseph Sushil Rao, Harish Kumar Hanumappa, Elvis Peter Joseph, Raghunandan Gorantlu Chowdappa, Rakesh Ramesh

Erschienen in: Indian Journal of Surgical Oncology | Ausgabe 3/2019

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Abstract

Neutrophil–Lymphocyte Ratio (NLR) provides an understanding of the systemic inflammatory conditions. NLR plays an important role as a predictor of mortality in breast and other malignancies. The application of NLR to predict prognosis of Locally Advanced Breast Cancer (LABC) has not been well developed. In this retrospective study, we establish a relationship of pre-treatment NLR with the Pathological Complete Response (pCR) in LABC patients to enhance decision-making and treatment protocols. Data of women diagnosed with carcinoma breast between January 2015 and December 2017 was retrieved from hospital records of a tertiary medical centre in Bangalore, India, after obtaining institutional ethical clearance. LABC patients were categorized into pCR(+) and pCR(−). NLR was calculated and divided into quartiles. The cutoff NLR was determined using the Receiver Operating Characteristic (ROC) curve. Statistical analysis was performed on 119 LABC patients, of which 25 (21%) achieved pCR. Oestrogen Receptor (ER) positivity was significantly lower in pCR(+) than in pCR(−) (p = 0.012). NLR of 2.46 (AUC, 0.744; 95% CI [0.201–0.584]; p = 0.056) was considered the optimum cutoff for pCR(+). A sensitivity of 54%, specificity of 8%, positive predictive value of 1% and high Negative Predictive Value (NPV) of 84% was achieved in the study. A relationship between pCR and the pre-treatment NLR determined a significantly high NPV. Poor pCR in luminal A/B subtype presents with elevated NLR. Therefore, in luminal type A/B (ER- and PR-positive) with elevated NLR (poor outcome) and low pCR (poor response to NACT), the decision of eliminating NACT could be considered, thereby recommending surgical intervention.
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Metadaten
Titel
Elevated Neutrophil–Lymphocyte Ratio in Luminal-Type Locally Advanced Breast Cancer to Circumvent Neo-Adjuvant Chemotherapy
verfasst von
Joseph Sushil Rao
Harish Kumar Hanumappa
Elvis Peter Joseph
Raghunandan Gorantlu Chowdappa
Rakesh Ramesh
Publikationsdatum
15.06.2019
Verlag
Springer India
Erschienen in
Indian Journal of Surgical Oncology / Ausgabe 3/2019
Print ISSN: 0975-7651
Elektronische ISSN: 0976-6952
DOI
https://doi.org/10.1007/s13193-019-00944-3

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