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BMC Cancer

, 15:195

Clinical oncology


BackgroundThere is a growing body of evidence that immune response plays a large role in cancer outcome. The neutrophil to lymphocyte ratio NLR has been used as a simple parameter of systemic inflammation in several tumors. The purpose was to investigate the association between pre-treatment NLR, disease-free survival and overall survival in patients with early triple negative breast cancer TNBC.

MethodsWe reviewed the records of patients with stage I-III TNBC at our Institution from 2006 to 2012. The association between pre-treatment NLR and survival was analyzed. The difference among variables was calculated by chi-square test. DFS and OS were estimated using Kaplan-Meier method. Cox analysis was performed to analyze clinical parameters for their prognostic relevance.

ResultsA total of 90 patients were eligible. There was no significant correlation among pre-treatment NLR and various clinical pathological factors. Patients with NLR higher than 3 showed significantly lower DFS p = 0.002 and OS p = 0.009 than patients with NLR equal or lower than 3. The Cox proportional multivariate hazard model revealed that higher pre-treatment NLR was independently correlated with poor DFS and OS, with hazard ratio 5.15 95% confidence interval CI 1.11-23.88, p = 0.03 and 6.16 95% CI 1.54-24.66, p = 0.01 respectively.

ConclusionOur study suggests that pre-treatment NLR may be associated with DFS and OS patients with early TNBC. Further validation and a feasibility study are required before it can be considered for clinical use.

KeywordsNeutrophil Lymphocyte Ratio Prognosis Survival Triple negative Breast cancer AbbreviationsCTLCytotoxic T Lymphocytes

CRPSystemic C-reactive protein

DFSDisease free-survival

EROestrogen receptor

HER-2Human epidermal growth factor receptor 2



MMMMatrix metalloproteinases

NLRNeutrophil to lymphocyte ratio

dNLRDerived neutrophil to lymphocyte ratio

OSOverall survival

PLRPlatelet to lymphocyte ratio

PRProgesteron receptor

SLESystemic lupus Erythematosus

SSASerum amyloid A

TNBCTriple negative breast cancer

VEGFVascular endothelial growth factor

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Autor: Mirco Pistelli - Mariagrazia De Lisa - Zelmira Ballatore - Miriam Caramanti - Alessandra Pagliacci - Nicola Battelli - Franc


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