Increased derived neutrophil-to-lymphocyte ratio and Breast Imaging-Reporting and Data System classification predict poor survival in patients with non-distant metastatic HER2+ breast cancer treated with neoadjuvant chemotherapy

Figures & data

Table 1 Relationship between dNLR and clinicopathological features in 310 patients with HER2+ breast cancer

Parameters	dNLR <2.7	dNLR ≥2.7	P-value
Age	43.5±12.4	45.2±10.5	0.812
Tumor size
T1	54	4	0.005
T2	120	48
T3	50	22
T4	8	4
Lymph node metastasis
N0	92	20	0.052
N1	46	24
N2	38	10
N3	56	24
AJCC stage
I	38	4	0.042
II	92	36
III	102	38
Lymphovascular invasion
Yes	36	26	0.001
No	196	52
Pathological type
IDC	191	60	0.293
ILC	41	18
Histological grade
I	32	2	<0.001
II	110	42
III	84	22
Unknown	8	10

Abbreviations: AJCC, American Joint Committee on Cancer; dNLR, derived neutrophil-to-lymphocyte ratio; IDC, invasive ductal carcinoma; ILC, invasive lobular carcinoma.

Table 2 Univariate and multivariate analyses of OS in HER2+ breast cancer

Parameters	Univariate analysis		Multivariate analysis
	HR (95% CI)	P-value	HR (95% CI)	P-value
Age (years)
≥50 vs<50	1.083 (0.731–1.652)	0.698	1.025 (0.632–1.686)	0.896
Tumor size
≥2 vs<2	3.542 (2.038–5.695)	<0.001	2.623 (1.562–4.652)	<0.001
Lymph node metastasis
Yes vs no	2.532 (1.815–3.726)	<0.001	1.426 (0.897–2.356)	0.132
Histological grade
G3 vs G1/2	2.651 (1.786–3.689)	<0.001	2.013 (1.262–3.562)	0.001
Lymphovascular invasion
Yes vs no	2.753 (1.952–3.856)	<0.001	1.653 (0.965–2.124)	0.086
BI-RADS
5 vs 3–4	2.285 (1.512–3.263)	<0.001	1.609 (1.216–2.351)	0.015
dNLR
≥2.5 vs<2.5	1.895 (1.152–2.862)	<0.001	1.726 (1.072–2.662)	0.009

Abbreviations: BI-RADS, Breast Imaging-Reporting and Data System; dNLR, derived neutrophil-to-lymphocyte ratio; OS, overall survival.

Table 3 Univariate and multivariate analyses of DFS in HER2+ breast cancer

Parameters	Univariate analysis		Multivariate analysis
	HR (95% CI)	P-value	HR (95% CI)	P-value
Age (years)
≥50 vs<50	0.963 (0.925–1.015)	0.562	0.826 (0.652–1.162)	0.216
Tumor size
≥2 vs<2	2.862 (1.896–4.562)	<0.001	2.153 (1.352–3.653)	0.002
Lymph node metastasis
Yes vs no	2.256 (1.547–3.256)	<0.001	1.315 (0.863–2.153)	0.268
Histological grade
G3 vs G1/2	3.256 (2.356–5.125)	<0.001	2.562 (1.796–4.152)	<0.001
Lymphovascular invasion
Yes vs no	2.956 (2.036–4.352)	<0.001	2.263 (1.265–2.965)	0.001
BI-RADS
5 vs 3–4	2.562 (1.756–3.562)	<0.001	1.925 (1.526–2.635)	0.021
dNLR
≥2.5 vs<2.5	1.856 (1.325–2.976)	<0.001	1.658 (1.125–2.426)	0.026

Abbreviations: BI-RADS, Breast Imaging-Reporting and Data System; DFS, disease-free survival; dNLR, derived neutrophil-to-lymphocyte ratio.

Figure 1 Overall survival of patients with HER2+ breast cancer stratified by dNLR.

Abbreviation: dNLR, derived neutrophil-to-lymphocyte ratio.

Figure 2 Disease-free survival of patients with HER2+ breast cancer stratified by dNLR.

Abbreviation: dNLR, derived neutrophil-to-lymphocyte ratio.

Figure 3 Overall survival of patients with HER2+ breast cancer stratified by BI-RADS classification.

Abbreviation: BI-RADS, Breast Imaging-Reporting and Data System.

Figure 4 Disease-free survival of patients with HER2+ breast cancer stratified by BI-RADS classification.

Abbreviation: BI-RADS, Breast Imaging-Reporting and Data System.