Lymphocyte-to-Monocyte Ratio is Associated with the Poor Prognosis of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Abstract

Purpose

Systemic inflammatory cell ratio, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and lymphocyte–monocyte ratio (LMR) are used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory markers for pathological response and prognosis in breast cancer patients receiving neoadjuvant chemotherapy (NAC).

Methods

In this study, we collected data of 203 breast cancer patients who underwent surgery after receiving standard neoadjuvant therapy. The effects of NLR, PLR, and LMR on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ² test and Cox regression analyses.

Results

We found that 27 of the 203 patients (13.3%) had local or distant metastases. The peripheral blood NLR, PLR, and LMR areas under the curve (AUC) were 0.674 (0.555–0.793), 0.630 (0.508–0.753), and 0.773 (0.673–0.874), respectively. The optimal cutoff values were 3.0, 135, and 6.2, respectively. Univariate and multivariate analyses revealed that LMR was related to the pathological complete response (pCR) rates and breast cancer DFS (P < 0.05). Among all patients, those with low LMR, HER-2 positive, and lymph node status (N2–3) demonstrated poor DFS.

Conclusion

Our study thus demonstrated that LMR can act as a potential marker for predicting the efficacy and prognosis of patients with breast cancer.

Keywords:

• breast cancer
• platelet-lymphocyte ratio
• neutrophil–lymphocyte ratio
• lymphocyte–monocyte ratio
• disease-free survival

Abbreviations

AUC, area under curve; 95% CI, 95% confidence interval; DFS, disease-free survival; OS, overall survival; NLR, neutrophil–lymphocyte ratio; PLR, platelet–lymphocyte ratio; LMR, lymphocyte–monocyte ratio; TNBC, triple negative breast cancer; HR, hazard ratio; pCR, pathological complete response; cTNM, clinical tumor-node-metastasis; SPSS, Statistical Product and Service Solutions.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

This research was conducted in accordance with the standards set out in the Declaration of Helsinki. This study was approved by the Medical Ethics Committee of Henan Cancer Hospital (Research Approval Number: 2,020,051,313). The Medical Ethics Committee of Henan Cancer Hospital did not require patients to agree to review their medical records (On the premise of not disclosing the privacy of patients, doctors can use it for clinical research).

Disclosure

The authors report no conflicts of interest for this work.