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Peripheral inflammation/immune indicators of chemosensitivity and prognosis in breast cancer patients treated with neoadjuvant chemotherapy

Authors Qian Y, Tao J, Li X, Chen H, Lu Q, Yang J, Pan H, Wang C, Zhou W, Liu X

Received 7 August 2017

Accepted for publication 30 January 2018

Published 15 March 2018 Volume 2018:11 Pages 1423—1432

DOI https://doi.org/10.2147/OTT.S148496

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr William Cho


Yi Qian,1,* Jing Tao,1,2,* Xiuqing Li,3 Hua Chen,1 Qi Lu,1 Junzhe Yang,1 Hong Pan,1 Cong Wang,4 Wenbin Zhou,1 Xiaoan Liu1

1
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China; 2Department of General Surgery, Nanjing Pukou Hospital, Nanjing, China; 3Department of Pathology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China; 4Department of Pathology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China

*These authors contributed equally to this work

Introduction: Neoadjuvant chemotherapy (NAC) has become a standard treatment for locally advanced breast cancer. The present study was designed to investigate the predictive value of different peripheral inflammation/immune biomarker responses to NAC and prognosis in breast cancer patients.
Materials and methods: A total of 180 breast cancer patients treated with NAC in the First Affiliated Hospital with Nanjing Medical University between January 2008 and March 2015 were enrolled in the study. The associations between inflammation/immune indicators and pathological complete response (pCR) were determined, and the prognostic value of inflammation/immune indicators was also evaluated.
Results: In the univariate analysis, patients with a high pretreatment peripheral lymphocyte count (>2.06×109/L) showed a higher pCR rate than those with a low lymphocyte count (23.9% vs 10.4%, P=0.023). The pCR rate of patients with a neutrophil: lymphocyte ratio ≤2.15 was significantly higher than that of patients with a high neutrophil: lymphocyte ratio (20% vs 7.8%; P=0.03). However, multivariate analysis revealed that only the high lymphocyte count was predictive for pCR (odds ratio: 4.375, 95% CI: 1.429–13.392, P=0.010). In the survival analysis, patients with a higher neutrophil count (>2.65×109/L) were confirmed to have a shorter disease-free survival (hazard ratio: 4.322, 95% CI: 1.028–18.174, P=0.046), and the high neutrophil count was significantly associated with lymphovascular invasion (P=0.037).
Conclusion: We demonstrated that a high level of baseline peripheral lymphocyte count can be a predictor for high efficacy of NAC for breast cancer patients, and low baseline peripheral neutrophil count may contribute to the favorable disease-free survival.

Keywords:
breast cancer, lymphocytes, neoadjuvant chemotherapy, neutrophils, pathologic complete response

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