Pretreatment Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Stage Determination in Breast Cancer

Sinta Wiranata; Ida Ayu Widya Anjani; I Putu Gede Septiawan Saputra; I Gusti Ayu Stiti Sadvika; I Putu Yuda Prabawa; I Gede  Supadmanaba; Desak Made  Wihandani; Putu Anda Tusta  Adiputra; I Wayan  Sudarsa; Anak Agung Wiradewi Lestari

doi:10.3889/oamjms.2020.5336

Authors

Sinta Wiranata Medical Student, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
Ida Ayu Widya Anjani Medical Student, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
I Putu Gede Septiawan Saputra Medical Student, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
I Gusti Ayu Stiti Sadvika Medical Student, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
I Putu Yuda Prabawa Department of Clinical Pathology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
I Gede Supadmanaba Department of Biochemistry, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
Desak Made Wihandani Department of Biochemistry, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
Putu Anda Tusta Adiputra Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Udayana University, Sanglah General Hospital, Bali, Indonesia
I Wayan Sudarsa Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Udayana University, Sanglah General Hospital, Bali, Indonesia
Anak Agung Wiradewi Lestari Department of Clinical Pathology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.5336

Keywords:

Breast cancer, Platelet lymphocyte ratio, Staging

Abstract

BACKGROUND: Breast cancer tends to respond differently to treatments, which are usually determined by clinicopathological characteristics. Several studies evaluated the role of the peripheral blood test as diagnostic and prognostic markers in several types of solid cancer and neutrophil-to-lymphocyte ratio (NLR) and platelet-tolymphocyte ratio (PLR) are two of them which already tested. However, the evidence in breast cancer is still lacking.

AIM: Therefore, the study aimed to investigate the value of NLR and PLR as biomarkers concerning breast cancer stage.

METHODS: A retrospective study was conducted using breast cancer patients’ medical records from 2014 to 2019 at Sanglah General Hospital. The histopathological records and complete blood counts of the patients were collected and analyzed risk analysis model, receiver operator characteristics analysis, and correlation of NLR and PLR with cancer staging analysis used correlation test.

RESULT: One hundred five patients data were used in this study, with 35 subjects had early-stage breast cancer while 70 subjects had an advanced stage. Breast cancer staging with NLR and PLR showed significant associations (p < 0.001). Both NLR and PLR had area under the curve >0.7 (p < 0.001). The cutoff, sensitivity, and specificity values of NLR and PLR were 2.504 (71%; 70%) and 157.1 (73%; 70%). Advanced stage of breast cancer was mostly found in high NLR and PLR value with (OR: 4.231; CI = 1.791-9.995, p < 0.001) and (OR: 3.949; 95% CI = 1.679–9.287; p < 0.001).

CONCLUSION: From this preliminary study, pretreatment NLR and PLR values might determine the breast cancer stage. Further research is needed to evaluate the association between grade and patient survival.

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