Sifón Maria Del Rosario, Marcolini Nicolas, Barber Maria Julia, Mclean Ignacio, Rizzo Manglio, Rivero Sergio, Costanzo Maria Victoria, Nervo Adrian, Crimi Gabriel, Perazzo Florencia, Levy Estrella Mariel, Mandó Pablo
Clinical Oncology, Centro de Educación médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina.
Clinical Oncology, Hospital Universitario Austral (HUA), Buenos Aires, Argentina.
Breast Care (Basel). 2022 Dec;17(6):546-553. doi: 10.1159/000525287. Epub 2022 Jun 3.
Breast cancer is a highly heterogeneous disease with large differences in the risk of recurrence. An elevated neutrophil-to-lymphocyte ratio (NLR) is correlated with a poor prognosis in a variety of tumors, and although it is still controversial in breast cancer, there are multiple studies, including meta-analysis, suggesting this. The purpose of this study was to analyze the prognostic value of preoperative NLR in an Argentine population of patients with nonmetastatic breast cancer, not exposed to neoadjuvant treatment.
Retrospective multicenter cohort study that includes patients over 18 years of age from three centers in the city and province of Buenos Aires who have had surgery for early breast cancer between January 1, 1999, and December 31, 2014. Based on the previous literature, a cutoff value of 2.0 was defined.
A total of 791 patients were eligible for the analysis. Median age was 55 years (IQR 45-65). Median NLR was 1.92 (IQR 1.50-2.56). The distribution of groups according to the 8th edition of the AJCC was 54.1% for stage I, 35.6% stage II, and 10.4% stage III. Among the different tumor phenotypes, 79.0% were HR+/HER2-, 11.4% were HR+ or-/HER2+, and 9.2% were HR-/HER2-. With a median follow-up of 5.3 years, 112 patients (14.2%) had disease recurrence. Stage III patients had a higher NLR than stage I and stage II patients ( = 0.002). The rest of the clinical and pathological characteristics did not show differences in the groups according to NLR. There were no differences in relapse-free survival according to the NLR ( = 0.37), and it did not change after adjusting for other prognostic variables.
We consider it is important to determine the efficacy of prognostic markers that are easily accessible and of simple, systematic application. However, NLR does not appear to be an independent prognostic factor for recurrence in our population. In this sense, we consider it is important to publish negative results in order to avoid publication bias.
乳腺癌是一种高度异质性疾病，复发风险差异很大。中性粒细胞与淋巴细胞比值（NLR）升高与多种肿瘤的预后不良相关，尽管在乳腺癌中仍存在争议，但包括荟萃分析在内的多项研究表明了这一点。本研究的目的是分析术前NLR在未接受新辅助治疗的阿根廷非转移性乳腺癌患者人群中的预后价值。
回顾性多中心队列研究，纳入了1999年1月1日至2014年12月31日期间在布宜诺斯艾利斯市和省的三个中心接受早期乳腺癌手术的18岁以上患者。根据先前的文献，定义临界值为2.0。
共有791例患者符合分析条件。中位年龄为55岁（四分位间距45 - 65岁）。中位NLR为1.92（四分位间距1.50 - 2.56）。根据美国癌症联合委员会（AJCC）第8版，I期患者占54.1%，II期患者占35.6%，III期患者占10.4%。在不同的肿瘤表型中，79.0%为HR + /HER2 - ，11.4%为HR + 或 - /HER2 + ，9.2%为HR - /HER2 - 。中位随访5.3年，112例患者（14.2%）出现疾病复发。III期患者的NLR高于I期和II期患者（P = 0.002）。其余临床和病理特征在根据NLR分组的患者中未显示出差异。根据NLR，无复发生存率无差异（P = 0.37），在调整其他预后变量后也未改变。
我们认为确定易于获取且应用简单、系统的预后标志物的有效性很重要。然而，在我们的人群中，NLR似乎不是复发的独立预后因素。从这个意义上讲，我们认为发表阴性结果以避免发表偏倚很重要。
