Correlation of Neutrophil-Lymphocyte and Albumin-Globulin Ratios With Outcomes in Patients With Breast Cancer Undergoing Neoadjuvant Chemotherapy or Upfront Surgery

Shi Hui Yang ¹, Min Li Tey ², Siqin Zhou ³

⁰Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore. christina.yang.s.h@singhealth.com.sg.

Journal of Breast Cancer +

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March 26, 2024

View abstract on PubMed

Summary

The neutrophil-lymphocyte ratio (NLR) and albumin-globulin ratio (AGR) can predict breast cancer treatment response and patient outcomes. Higher AGR and lower NLR are associated with better survival and treatment efficacy.

Area Of Science

Oncology
Immunology
Biochemistry

Background

The neutrophil-lymphocyte ratio (NLR) is a marker of systemic inflammation associated with poorer cancer prognosis.
The albumin-globulin ratio (AGR) may reflect nutritional status and immune function, potentially indicating a better prognosis.

Purpose Of The Study

To investigate the association between NLR, AGR, and treatment response and survival in breast cancer patients.
To determine the prognostic value of NLR and AGR in different breast cancer treatment settings.

Main Methods

Retrospective analysis of 1,188 patients with stage I-III breast cancer (2011-2017).
Multivariate logistic regression and Cox regression analyses were used to assess NLR and AGR in relation to treatment outcomes and survival.
Patients were stratified based on neoadjuvant chemotherapy (NACT) or upfront surgery.

Main Results

In NACT patients, higher AGR correlated with increased pCR rates, improved DFS, and CSS. Higher NLR was linked to worse DFS and CSS.
In upfront surgery patients, higher AGR was associated with better OS, while higher NLR correlated with worse OS.
Specific cut-off values for NLR and AGR were identified for predicting outcomes in both treatment groups.

Conclusions

NLR and AGR serve as valuable predictive markers for neoadjuvant chemotherapy response and overall prognosis in breast cancer.
These ratios may aid in clinical decision-making, although further research is warranted.

Keywords:

Albumins Breast Neoplasms Globulins Lymphocytes Neutrophils