The Ratio of Monocyte to Apolipoprotein A1 is an Independent Predictor of Breast Cancer: A Retrospective Study

Figures & data

Table 1 Comparison of Hematological Parameters Among Patients with Breast Cancer, Those with Benign Breast Disease and Healthy Volunteers

Group	Breast Cancer	Benign Breast Disease	Healthy Volunteers	F	P
N	276	118	219
Age	50±10	49±12	48±10	1.297	0.274
E	0.13(0.00–1.37)	0.13(0.03–0.62)	0.14(0.00–1.37)	0.158	0.924
B	0.04(0.00–0.21)	0.03(0.01–0.10)^a	0.03(0.01–0.06)^b	6.417	0.04
TCHO	4.64(2.79–7.75)	4.56(2.57–7.21)	4.31(3.10–5.20)^b	28.824	<0.001
TG	1.02(0.27–7.31)	0.85(0.29–4.08)^a	1.15(0.56–1.7)^b	11.083	0.004
LDL-C	2.85(1.27–5.51)	2.89(1.43–5.36)	2.95(2.70–3.13)	2.849	0.241
ApoA1	1.32(0.69–1.91)	1.35(0.86–2.00)^a	1.39(1.20–1.62)^b	17.380	<0.001
ApoB	0.85(0.37–1.48)	0.85(0.51–1.27)	0.95(0.80–1.06)^b	27.563	<0.001
Lp(a)	0.14(0.00–3.29)	1.21(0.02–1.35)	0.16(0.00–0.31)^b	2.138	0.343
NLR	1.86(0.30–26.51)	1.61(0.69–5.45)^a	1.64(0.75–4.70)^b	16.605	<0.001
PLR	137(54–683)	120(54–298)^a	122(62–288)^b	22.403	<0.001
LMR	4.16(0.65–9.64)	5.10(1.93–10.23)^a	5.20(1.93–10.05)^b	60.952	<0.001
NAR	2.86(0.37–35.72)	2.49(0.94–9.69)^a	2.54(1.19–5.25)^b	11.844	0.003
LAR	1.53(0.49–3.48)	1.64(0.82–3.08)^a	1.55(0.72–2.67)	4.896	0.086
MAR	0.40±0.16	0.35±0.13^a	0.30±0.08^b	32.171	<0.001
PAR	207(88–697)	195(92–433)^a	191(87–292)^b	19.882	<0.001
HAR	0.98(0.14–1.80)	0.99(0.44–1.53)	0.98(0.72–1.29)	1.391	0.499
BAR	0.65(0.31–1.23)	0.62(0.35–0.99)^a	0.67(0.50–0.88)	10.299	0.006

Notes: ^aBreast cancer vs Benign breast disease (P<0.05, LSD/Mann Whitney U-test). ^bBreast cancer vs Healthy volunteers (P<0.05, LSD/Mann Whitney U-test). P value is analyzed by one-way ANOVA tests or Kruskal–Wallis H-test.

Abbreviations: E, Eosinophils; B, Basophil; TCHO, total cholesterol; TG, triglyceride; LDL, low density lipoprotein cholesterol; ApoA1, apolipoprotein A1; ApoB, apolipoprotein B; Lp(a), lipoprotein a; NLR, neutrophil-to-lymphocyte; PLR, platelet-to-lymphocyte; NAR, neutrophil-to-apolipoprotein A1; LAR, lymphocyte-apolipoprotein A1; MAR, monocytes-to-apolipoprotein A1; PAR, platelet-to-apolipoprotein A1; HAR, high-density lipoprotein-to-apolipoprotein A1; BAR, apolipoprotein B-to-apolipoprotein A1.

Figure 1 Difference of MAR among patients with breast cancer, those with benign breast disease and healthy volunteers.

Table 2 Identification of Optimal Cut-off Values for Different Predictive Factors Based on the ROC Curve

Group	BC vs BBD			BC vs HV
Parameter	Cut off	AUC	Youden	Cut off	AUC	Youden
NLR	>1.84	0.613	0.204	>1.96	0.580	0.169
PLR	>147.83	0.614	0.206	>146.26	0.609	0.202
NAR	>3.30	0.579	0.162	>2.91	0.581	0.185
PAR	>241.03	0.572	0.136	>229.33	0.616	0.214
LAR	≤1.26	0.568	0.146	≤1.09	0.525	0.099
BAR	>0.73	0.550	0.124	≤0.59	0.540	0.244
MAR	>0.44	0.587	0.171	>0.37	0.683	0.318

Notes: The truncation value, AUC and Youden index of each valuable variable were calculated using the receiver operating characteristic curve.

Abbreviations: BC, breast cancer; BBD, benign breast disease; HV, Healthy volunteers; NLR, neutrophil-to-lymphocyte; PLR, platelet-to-lymphocyte; NAR, neutrophil-to-apolipoprotein A1; PAR, platelet-to-apolipoprotein A1; LAR, lymphocyte-apolipoprotein A1; BAR, apolipoprotein B-to-apolipoprotein A1; MAR, monocytes-to-apolipoprotein A1.

Figure 2 ROC curve analysis of MAR in patients with breast cancer and those with benign breast disease.

Figure 3 ROC curve analysis of MAR in patients with breast cancer and healthy volunteers.

Table 3 The Predictive Factors of the Two Groups Identified by Univariate and Multivariate Logistic Regression

Group	BC vs BBD				BC vs HV
Parameter	Univariate		Multivariate		Univariate		Multivariate
	OR	P	OR	P	OR	P	OR	P
Age	1.012	0.259			1.014	0.125
NLR	1.594	0.002	1.116	0.858	1.501	0.001	1.105	0.798
PLR	1.009	<0.001	1.014	0.212	1.009	<0.001	1.007	0.267
NAR	1.214	0.032	1.000	1.000	1.404	<0.001	0.905	0.743
PAR	1.004	0.040	0.993	0.351	1.009	<0.001	1.004	0.406
LAR	0.634	0.044	1.450	0.625
BAR	3.838	0.052	2.659	0.225
MAR	2.634	0.001	2.690	0.003	3.878	<0.001	3.733	<0.001

Abbreviations: BC, breast cancer; BBD, benign breast disease; HV, Healthy volunteers; NLR, neutrophil-to-lymphocyte; PLR, platelet-to-lymphocyte; NAR, neutrophil-to-apolipoprotein A1; PAR, platelet-to-apolipoprotein A1; LAR, lymphocyte-apolipoprotein A1; BAR, apolipoprotein B-to-apolipoprotein A1; MAR, monocytes-to-apolipoprotein A1.

Table 4 Analysis of MAR and Clinicopathological Staging of Breast Cancer Patients

	N	MAR	F	P
Tumor stage
I+II	203(73.6)	0.392±0.011	3.099	0.047
III	61(22.1)	0.396±0.021
IV	12(4.3)	0.510±0.078
Tumor invasion depth
1+2	225(81.5)	0.379±0.010	8.333	<0.001
3	38(13.8)	0.477±0.028
4	13(4.7)	0.484±0.072
Lymph node metastasis
0+1	229(83.0)	0.405±0.011	1.807	0.166
2	34(12.3)	0.375±0.025
3	13(4.7)	0.328±0.031
Distant metastasis
0	263(95.3)	0.392±0.009	1.854	0.095
1	13(4.7)	0.520±0.072

Notes: Data are expressed as mean±standard deviation or median (quartile), categorical variables were expressed as frequency (percentage). P value was analyzed by one-way ANOVA tests or t-test.

Abbreviation: MAR, monocytes-to-apolipoprotein A1.

Figure 4 Difference of MAR in breast cancer patients with diverse tumor stage (A) and depth of invasion (B).

Table 5 Correlation Between MAR and Clinicopathological Staging and Other Parameters of Breast Cancer Patients

Parameter	Monocytes-to-Apolipoprotein A1
	P	r
TNM stage	0.474^#	0.043
Tumor invasion depth	<0.001^#	0.210
Lymph node metastasis	0.050^#	−0.118
Distant metastasis	0.069^#	0.110
Albumin	0.187*	−0.080
Platelet	<0.001*	0.221
Neutrophils	<0.001*	0.484
Lymphocyte	0.861*	−0.011
Eosinophils	<0.001*	0.221
Basophil	0.127*	0.092
Total cholesterol	0.031*	−0.130
Triglyceride	0.281*	0.065
High density lipoprotein cholesterol	<0.001*	−0.350
Low density lipoprotein cholesterol	0.070*	−0.109
Apolipoprotein B	0.301*	−0.062
Lipoprotein a	0.857*	−0.011
Neutrophil-to-lymphocyte	<0.001*	0.400
Platelet-to-lymphocyte	<0.001*	0.248

Notes: ^#P value was analyzed by Spearman’s rho correlation. *P value was analyzed by Pearson correlation.