Prognostic value of pro-inflammatory markers at the preoperative stage in Algerian women with breast cancer

Characteristic		Untreated BC
Age Median (range)		46 (30–75)
T stage	T1	8 (13.55%)
	T2	30 (50.84%)
	T3	8 (13.55%)
T4	8 (13.55%)
ND	5 (8.47%)
N stage	N0	20 (33.89%)
	N1	28 (47.45%)
	N2	5 (8.47%)
N3	1 (1.69%)
ND	5 (8.47%)
Stage disease	IA	2 (3.39%)
	IIA	21 (35.59%)
	IIB	17 (28.81%)
	IIIA	6 (10.17%)
IIIB	8 (13.55%)
IIIC	1 (1.69%)
ND	4 (6.78%)
Laterality of tumor	Right breast	24 (40.67%)
Left breast	35 (59.32%)
Histological classification	CCI	49 (83.05%)
Histological classification	CLI	4 (6.78%)
Mixte	5 (8.47%)
colloid	1 (1.69%)
SBR classification	I	1 (1.69%)
	II	35 (59.32%)
	II/III	2 (3.39%)
III	20 (33.89%)
ND	1 (1.69%)
Molecular classification	Lum A	6 (10.17%)
	Lum B	24 (40.67%)
	Lum B-like	7 (11.86%)
HER2+	9 (15.25%)
TNBC	8 (13.55%)
Lum A or B	5 (8.47%)
Treatment	Chemotherapy	58/59
Treatment	Radiotherapy	51/59
Hormonotherapy	36/42
Anti-HER2	16/16

Table 2:

Baseline hematological values.

Blood values	Population
Mean white blood cell† (± SD)	6.926 (± 1.720)
Mean neutrophils† (± SD)	4.152 (± 1.307)
Mean lymphocytes† (± SD)	2.180 (± 0.6109)
Mean monocytes†, ‡ (± SD)	0.4483 (± 0.2294)
Mean platelets† (± SD)	264.553 (± 63.215)
Mean MLR‡ (± SD)	0.2256 (± 0.1675)
Mean NLR (± SD)	2.021 (± 0.7890)
Mean PLR (± SD)	130.8 (± 59.11)
Mean SIRI‡ (± SD)	0.8649 (±0.4827)
Mean SII (± SD)	530.5 (±209.3)

Note: Values represent mean ± standard deviations (SD).

Abbreviations: MLR, monocyte-to-lymphocyte ratio; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; SII, systemic immune-inflammatory index;

(‡): n=42;

(†): (10⁹ cells/L).

Table 3:

Optimal cutoff values of preoperative NLR, PLR, SII, MLR, SIRI for predicting RFS, DMFS, and OS in breast cancers.

Subgroups	Cutoff value	AUC	Sensitivity (%)	Specificity (%)	Youden index	95% CI of AUC	P-value
Recurrence-free survival
NLR	2.11	0.568	41.4	76.7	0.181	0.425–0.712	0.35
PLR	291.81	0.440	6.9	100	0.069	0.295–0.585	0.419
SII	472	0.578	69	53.3	0.223	0.434–0.722	0.287
MLR‡	0.16	0.693	85.7	57.1	0.428	0.538–0.847	0.014
SIRI‡	0.6888	0.741	85.7	57.1	0.428	0.598–0.885	0.001
Distant metastasis-free survival
NLR	1.6	0.59	88.9	34.1	0.23	0.434–0.746	0.258
PLR	128.33	0.497	50	63.4	0.134	0.334–0.660	0.974
SII	472	0.634	77.8	51.2	0.29	0.49–0.779	0.069
MLR‡	0.28	0.657	41.7	86.7	0.284	0.485–0.829	0.074
SIRI‡	0.6888	0.722	91.7	46.7	0.384	0.569–0.875	0.004
Overall survival
NLR	2.85	0.508	42.9	90.4	0.333	0.208–0.808	0.957
PLR	119.52	0.404	57.1	50	0.071	0.174–0.633	0.412
SII	712	0.544	42.9	80.8	0.237	0.295–0.793	0.730
MLR‡	0.11	0.559	100	18.9	0.189	0.3–0.819	0.653
SIRI‡	1.3823	0.605	40	86.5	0.265	0.346–0.865	0.426

Abbreviations: AUC, area under curve; CI, confidence interval; MLR, monocyte-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SII, systemic immune-inflammation index; NLR, neutrophil-to-lymphocyte ratio; SIRI, systemic inflammatory response index; RFS, relapse-free survival; DMFS, distant metastasis-free survival; OS, overall survival;

(‡): n=42.

Table 4:

Clinicopathological characteristics of breast cancers according to inflammatory markers for RFS and DMFS.

Subgroups	N	SII		P value	N	NLR		P value	N	MLR		P value	N	SIRI		P value
Subgroups		Low	High			Low	High			Low	High			Low	High
Recurrence-free survival
Age	59			0.601	59			0.7787	42			0.3357	42			0.3357
≤ 46		14	16			20	10			6	16			6	16
> 46		11	18			21	8			9	11			9	11
T staging	55			0.5648	55			0.2127	39			1	39			0.7281
T1+T2		16	23			29	10			10	16			11	15
T3+T4		8	8			9	7			5	8			4	9
N staging	55			1	55			0.7630	39			1	39			1
N0		9	11			13	7			4	7			4	7
N+		15	20			25	10			11	17			10	18
Clinical staging	55			1	55			0.1892	39			1	39			0.7281
I+II		17	23			30	10			10	16			11	15
III+IV		7	8			8	7			5	8			4	9
SBR classification	58			0.2661	58			1	41			1	41			0.1703
I+II		18	20			26	12			9	18			7	20
III		6	14			13	7			5	9			7	7
Laterality of tumor	59			0.7897	59			1	42			0.2072	42			1
Right breast		11	13			16	8			4	13			6	11
Left breast		14	21			24	11			11	14			9	16
Distant metastasis-free survival
Age	59			0.601	59			1	42			1	42			0.3357
≤ 46		14	16			8	22			17	5			6	16
> 46		11	18			8	21			16	4			9	11
T staging	55			0.5648	55			0.3263	39			0.1938	39			0.7281
T1+T2		16	23			9	30			23	3			11	15
T3+T4		8	8			6	10			9	4			4	9
N staging	55			1	55			0.5308	39			1	39			1
N0		9	11			4	16			9	2			4	7
N+		15	20			11	24			23	5			10	18
Clinical staging	55			1	55			0.7348	39			0.1938	39			0.7281
I+II		17	23			10	30			23	3			11	15
III+IV		7	8			5	10			9	4			4	9
SBR classification	58			0.2661	58			0.5413	41			0.6925	41			0.1703
I+II		18	20			11	27			20	7			7	20
III		6	14			4	16			12	2			7	7
Laterality of tumor	59			0.7897	59			0.1518	42			0.2708	42			1
Right breast		11	13			9	15			15	2			6	11
Left breast		14	21			7	28			18	7			9	16

Prognostic value of inflammatory markers for breast cancer patients. (A) Kaplan-Meier curves of RFS for NLR, MLR, SII and SIRI. (B) Kaplan-Meier curves of DMFS for NLR, MLR, SII and SIRI. (C) Kaplan-Meier curves of OS for SIRI.

Table 5:

Univariate Cox regression analysis for RFS.

	HR	95% CI	P
Age	1.237	0.596–2.568	0.569
T staging	1.318	0.611–2.845	0.482
N staging	1.265	0.56–2.858	0.572
SBR classification	1.055	0.478–2.328	0.894
NLR	1.532	0.73–3.217	0.26
SII	2.263	1.022–5.014	0.044
MLR‡	4.311	1.262–14.729	0.020
SIRI‡	3.845	1.116–13.246	0.033

[i] Abbreviations: HR, hazard ratio; CI, confidence interval.

Table 6:

Univariate Cox regression analysis for DMFS.

	HR	95% CI	P
Age	0.820	0.323–2.079	0.676
T staging	1.380	0.518–3.680	0.519
N staging	0.751	0.291–1.942	0.555
SBR classification	0.834	0.297–2.342	0.730
NLR	1.822	0.718–4.625	0.207
SII	3.118	1.023–9.501	0.045
MLR‡	5.556	1.707–18.085	0.004
SIRI‡	7.261	0.935–56.366	0.058

[i] Abbreviations: HR, hazard ratio; CI, confidence interval.

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DOI: https://doi.org/10.2478/fco-2023-0021 | Journal eISSN: 1792-362X | Journal ISSN: 1792-345X

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Language: English

Page range: 45 - 56

Submitted on: Oct 28, 2023

Accepted on: Jan 22, 2024

Published on: Jun 18, 2024

Published by: Helenic Society of Medical Oncology

In partnership with: Paradigm Publishing Services

Keywords:

breast cancer,

SII,

MLR,

SIRI,

Related subjects:

Haematology, oncology

© 2024 Ahmed Amine Zergoun, Syhem Braikia, Mohsen Wahib Boubnider, Kamel Bouzid, Chafia Touil-Boukoffa, published by Helenic Society of Medical Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 14 (2023): Issue 2 (December 2023)

Prognostic value of pro-inflammatory markers at the preoperative stage in Algerian women with breast cancer

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