Predictive efficacy of the preoperative neutrophil-lymphocyte ratio in lymph node metastasis of cN0 hormone receptor-positive breast cancer

Miao-Feng Wang ¹, Jia-Rui Cai ¹, Heng Xia ¹

⁰Department of Thyroid and Breast Surgery, Shaoxing Central Hospital (The Central Hospital of Shaoxing University), Shaoxing, 312030, Zhejiang Province, China.

Scientific Reports +

|

June 20, 2024

View abstract on PubMed

Summary

The neutrophil-to-lymphocyte ratio (NLR) is an independent risk factor for lymph node metastases in hormone receptor-positive breast cancer. An elevated NLR, especially ≥2.4, predicts a higher probability of metastases in early-stage patients.

Area Of Science

Oncology
Pathology

Background

Breast cancer is the most prevalent cancer globally.
Neutrophil-to-lymphocyte ratio (NLR) is increasingly recognized for its association with cancer development and patient outcomes.
Existing research suggests a link between NLR and lymph node metastasis in specific breast cancer subtypes.

Purpose Of The Study

To investigate the correlation between NLR and lymph node metastasis in clinically node-negative (cN0), hormone receptor-positive (HR(+)) breast cancer patients.
To determine if NLR is an independent predictor of lymph node metastasis in this patient cohort.

Main Methods

Retrospective analysis of 220 cN0 HR(+) invasive breast cancer patients diagnosed between January 2012 and January 2022.
Statistical examination of the relationship between NLR and pathological data.
Utilized Receiver Operating Characteristic (ROC) curve analysis to identify the optimal NLR cutoff, chi-squared tests for univariate analysis, and logistic regression for multivariate analysis.

Main Results

An optimal NLR cutoff of 2.4 was identified for predicting lymph node metastasis.
Patients with axillary lymph node metastases exhibited significantly higher NLR values (P < 0.05).
Univariate analysis revealed significant associations between lymph node metastasis and clinical stage, histological grade, Ki-67 levels, tumor size, and NLR (P < 0.05).
Multivariate analysis identified clinical stage, tumor size, and NLR as independent risk factors for lymph node metastasis.

Conclusions

Neutrophil-to-lymphocyte ratio (NLR) is an independent risk factor for lymph node metastasis in cN0 HR(+) breast cancer.
An NLR value of 2.4 or higher is associated with an increased likelihood of lymph node metastasis.
Preoperative NLR demonstrates significant predictive value for identifying axillary lymph node metastasis in this patient group.

Keywords:

Breast cancer Clinical stage Lymph node metastasis Neutrophil-to-lymphocyte ratio