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Prognostic value of preoperative inflammatory markers in Chinese patients with breast cancer

Authors Yao M, Liu Y, Jin H, Liu X, Lv K, Wei H, Du C, Wang S, Wei B, Fu P

Received 19 June 2014

Accepted for publication 16 July 2014

Published 26 September 2014 Volume 2014:7 Pages 1743—1752


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Minya Yao,1 Yu Liu,1 Hailong Jin,2 Xiaojiao Liu,1 Kezhen Lv,1 Haiyan Wei,1 Chengyong Du,1 Shuqian Wang,1 Bajin Wei,1 Peifen Fu1

1Department of Breast Center, 2Gastrointestinal Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China

Abstract: Cancer-associated inflammation is a key determinant of disease progression and survival in most cancers. The aim of our study was to assess the predictive value of preoperative inflammatory markers, such as the neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio, red cell distribution width (RDW), and mean platelet volume, for survival in breast cancer patients. In total, 608 breast cancer patients operated on between January 2009 and December 2011 were included in this observational study. The association between preoperative inflammatory markers and survival outcomes was analyzed. Patients with high NLR (>2.57) or high RDW (>13.45%) showed a significantly lower overall survival rate than those with lower NLR (≤2.57) or lower RDW (≤13.45%). NLR and RDW, along with node stage and molecular subtypes, were independent prognostic factors. There was a significant survival difference according to NLR in the luminal A and triple-negative subtypes (93.3% versus 99.3%, P=0.001; 68.8% versus 95.1%, P=0.000, respectively). The triple-negative subtype was the only subtype in which higher RDW patients showed significantly poor prognosis (81.3% versus 95.5%, P=0.025). Pre-operation NLR and RDW is a convenient, easily measured prognostic indicator for patients with breast cancer, especially in patients with the triple-negative subtype.

Keywords: neutrophil-to-lymphocyte ratio, NLR, red cell distribution width, RDW, overall survival

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