Al Jarroudi Ouissam, El Bairi Khalid, Abda Naima, Zaimi Adil, Jaouani Laila, Chibani Hind, Afqir Said
Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco.
Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco.
Biomark Med. 2021 Oct;15(14):1289-1298. doi: 10.2217/bmm-2020-0717. Epub 2021 Sep 6.
Inflammatory breast cancer (IBC) is uncommon, aggressive and associated with poor survival outcomes. The lack of prognostic biomarkers and therapeutic targets specific to IBC is an added challenge for clinical practice and research. Inflammatory biomarkers such as neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios (NLR and PLR) demonstrated independent prognostic impact for survival in breast cancer. In our study, these biomarkers were investigated in a cohort of patients with nonmetastatic IBC. A retrospective cohort of 102 IBC patients with nonmetastatic disease was conducted at the between January 2010 and December 2014. NLR and PLR were obtained from blood cell count at baseline before neoadjuvant chemotherapy (NACT) from patients' medical records. The receiver operating characteristic was used to find the optimal cut-off. Correlation between these blood-based biomarkers and response to NACT was analyzed by Chi-squared and Fisher's exact test. Their prognostic value for predicting disease-free survival (DFS) and overall survival (OS) was performed based on Cox regression models. Totally, 102 patients with IBC were included in the analysis. Pathologic complete response (pCR) after NACT, defined by the absence of an invasive tumor in the breast tissues and nodes after surgery (ypT0 ypN0), was observed in eight patients (7.8%). NACT response was found to be associated with menopausal status (p = 0.039) and nodal status (p < 0.001). Patients with a low NLR had a higher pCR rate as compared with the high-NLR group (p = 0.043). However, the pCR rate was not significantly associated with age (p = 0.122), tumor side (p = 0.403), BMI (p = 0.615), histological grade (p = 0.059), hormone receptors status (p = 0.206), HER2 (p = 0.491) and PLR (p = 0.096). Pre-treatment blood-based NLR of 2.28 was used as the cut-off value to discriminate between high and low NLR according to the receiver operating characteristic curves. Similarly, a value of 178 was used as the cut off for PLR. Patients with low-NLR had a significantly better 5-year DFS (p < 0.001) and OS (p < 0.001) than the high-NLR group. Moreover, low-PLR was significantly associated with higher DFS (p = 0.001) and OS (p = 0.003). The NLR showed a significant prognostic impact for DFS (HR: 2.57; 95% CI: 1.43-4.61; p = 0.01) and for OS (HR: 2.92; 95% CI: 1.70-5.02; p < 0.001). Similarly, a meaningful association between PLR and 5-year DFS (HR: 1.95; 95% CI: 1.10-3.46; p = 0.021) and OS (HR: 1.82; 95% CI: 1.06-3.14; p = 0.03) was noticed. High NLR and PLR were found associated with reduced DFS and OS in nonmetastatic IBC. Further studies are awaited to confirm these findings.
炎性乳腺癌（IBC）并不常见，具有侵袭性，且与较差的生存结果相关。缺乏IBC特异性的预后生物标志物和治疗靶点给临床实践和研究带来了额外挑战。中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值（NLR和PLR）等炎性生物标志物对乳腺癌生存显示出独立的预后影响。在我们的研究中，对一组非转移性IBC患者的这些生物标志物进行了研究。2010年1月至2014年12月期间，对102例非转移性IBC患者进行了回顾性队列研究。NLR和PLR从患者病历中获取新辅助化疗（NACT）前基线血细胞计数。使用受试者工作特征曲线来确定最佳临界值。通过卡方检验和Fisher精确检验分析这些基于血液的生物标志物与NACT反应之间的相关性。基于Cox回归模型评估它们对预测无病生存期（DFS）和总生存期（OS）的预后价值。总共102例IBC患者纳入分析。NACT后病理完全缓解（pCR）定义为术后乳腺组织和淋巴结中无浸润性肿瘤（ypT0 ypN0），在8例患者（7.8%）中观察到。发现NACT反应与绝经状态（p = 0.039）和淋巴结状态（p < 0.001）相关。与高NLR组相比，低NLR患者的pCR率更高（p = 0.043）。然而，pCR率与年龄（p = 0.122）、肿瘤侧别（p = 0.403）、BMI（p = 0.615）、组织学分级（p = 0.059）、激素受体状态（p = 0.206）、HER2（p = 0.491）和PLR（p = 0.096）均无显著相关性。根据受试者工作特征曲线，将治疗前基于血液的NLR 2.28用作区分高NLR和低NLR的临界值。同样，将178用作PLR的临界值。低NLR患者的5年DFS（p < 0.001）和OS（p < 0.001）明显优于高NLR组。此外，低PLR与更高的DFS（p =
