Blood cellular markers of inflammation in Breast Cancer and response to Neoadjuvant Chemotherapy
DOI:
https://doi.org/10.30442/ahr.0501-13-43Keywords:
Biomarkers, Blood cellular markers, Breast cancer, Neoadjuvant chemotherapy, Response rateAbstract
Background: Breast cancer is the most common female malignancy in Nigeria. Neoadjuvant chemotherapy is the first line treatment for locally advanced breast cancer. The advancement of many cancers is accompanied by inflammation, and inflammatory cells play an essential role in the progression.
Objective: To determine if haematological parameters can predict the responsiveness of breast cancer to neoadjuvant chemotherapy regime.
Method: A prospective cohort study of all breast cancer patients who had neoadjuvant chemotherapy between July 2017 and December 2018 was carried out. Haematological parameters of red cell count (RCC), white cell count(WCC), neutrophil count (NC), lymphocyte count (LC), platelet count (PC), red cell distribution width (RCDW), mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were measured. Response to chemotherapy was assessed by measuring the longest diameter of the lump and largest lymph node and applying the UICC criteria.
Results: Thirty-five females with breast cancer with the age range of 33-82 years and mean age of 48 ± 11 years were studied. The overall clinical response rate was 80% consisting of 40% complete clinical response, 40% partial clinical response, 8.6% stable disease and 11.4% progressive disease. Eleven (78.6%) with PLR values below average had good clinical response while 21.4% of those with PLR value above average had a good clinical response (χ2 = 8.4, p = 0.006)
Conclusion: The study showed that PLR is associated with complete clinical response to neoadjuvant chemotherapy and should be used as part of routine assessment before chemotherapy.
References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer J Clin 2018; 68: 394-424. doi.org 10.3322/caac21492.
Adebamowo CA, Ajayi OO. Breast Cancer in Nigeria. West Afr J Med 2000; 19: 179-191.
Ayoade BA, Agboola AJ, Olatunji AA, Tade AO, Salami BA and Adekoya AO. Clinical characteristics and survival outcome of Breast Cancer in Southwest Nigerian women. J Afr Cancer 2014; 6: 79-84. DOI 10.1007/s12558-014-0311-8.
Schwartz GF, Hortobagyi GN. Proceedings of consensus conference on neoadjuvant chemotherapy in carcinoma of the breast, April 26-28 2003, Philadephia, Pennsylvania. Cancer 2004; 100:2512.
Hayward JL, Carbone PP, Heuson JC, Kumaoka S, Segaloff A, Rubens RD. Assessment of response to therapy in advanced breast cancer: a project of the Programme on Clinical Oncology of the International Union Against Cancer, Geneva Switzerland. Cancer 1977; 39: 1289-1294.
Okada F. Inflammation-related carcinogenesis: current findings in epidemiological trends, causes and mechanism. Yonago Acta Med 2014; 57: 65-72.
Matsunaga A, Tagata T, Hamano T, Teramoto H, Kan M, Matsunaga Y, et al. Metachronous early gastric cancer over a period of 13years after eradication of Helicobacter pylori. Clin J Gastroenterol 2014; 7: 490-495.
Hoshida Y, Fuchs BC, Bardeesy N, Baumert TF, Chung RT .Pathogenesis and prevention of hepatitis C virus-induced hepatocellular carcinoma. J Hepatol 2014; 61:79-90.
Aggarwal BB, Gehlot P. Inflammation and cancer: how friendly is the relationship for cancer patients? Curr Opin Phamacol 2009; 9: 351-369.
Thavaramara T, Phaloprakam C, Tangjitgamol S, Manusirivithaya S. Role of neutrophil to lymphocyte ratio as a prognostic indicator for epithelial ovarian cancer. J Med Assoc 2011; 94: 871-877.
Aliustaoglu M, Bilici A, Ustaalioglu BB, Konya V, Gucun M, Seker M, et al. The effect of peripheral blood values on prognosis of patients with locally advanced gastric cancer before treatment. Med Oncol 2010; 27: 1060-1065.
Unal D, Eroglu C, Kurtul N,Oguz A,Tasdemir A. Are neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? Asia Pac J Cancer Prev 2013; 14: 5237-5242.
Wang C, Civan J, Lai Y, Cristofanilli M, Hyslop T, Palazzo JP , et al. Racial disparity in breast cancer survival: the impact of pre-treatment hematologic variables. Cancer Causes Control. 2015; 26 (1): 45-46.
Chen J, Deng Q, Pan Y, He B, Ying H, Sun H, et al. Prognostic value of neutrophil-to-lymphocyte ratio in breast cancer. FEBS Open Bio 2015; 20: 502-507.
Gu M, Zhai Z, Huang L, Zeheng W, Zhou Y, Zhu R, et al. Pre-treatment mean platelet volume associates with worse clinicopathologic features and prognosis of patients with invasive breast cancer. Breast Cancer. 2016; 23: 752-760.
Oluwole SF, Fadiran OA, Odesanmi WO. Diseases of the breast in Nigeria. Br J Surg 1987; 74: 582-585.
Akanni EO, Oguntola AS, Adeoti ML, Agodirin SA. Haematological Parameters in Female patents in South Western Nigeria. Int J Med Health Sci, 2013; 2(4): 398-401.
Akinbami A, Popoola A, Adediran A, Dosunmu A, Oshinaike O, Adebola P et al. Full blood count pattern of prechemotherapy breast cancer patients in Lagos, Nigeria. Caspian J Intern Med 2013; 4(1); 574-579.
Asano Y, Kashiwagi S, Onoda N, Noda S, Kawajiri H, Takashima T, et al. Platelet-Lymphocyte Ratio as a Useful Predictor of the Therapeutic effect of Neoadjuvant Chemotherapy in Breast Cancer. PLoS ONE 2016: 11(7): e)153459. doi: 10.1371/journal.pone.0153459.
Rafee S, McHugh D, Greally M, Ayodele O, Keegan N, Lim M et al. Neutrophil to Lymphocyte ratio (NLR) and Platelet to lymphocyte ratio (PLR) as predictive biomarkers of pathologic complete response (PCR) in neoadjuvant breast cancer: an Irish Clinical Oncology Group study (ICORG 16-20). Ann Oncol 2016; 27(Suppl6): 1538P.
Cuello-Lopez J, Fidalgo-Zapata A, Lopez-Agudelo L, Vasquez-Trespalacios E, Platelet to lymphocyte ratio as a predictive factor of complete pathologic response to neoadjuvant chemotherapy in breast cancer. PLoS ONE 2018; 13 (11)::e0207224 .https//doi.org/10.1371 /journalpone0207224.
Seretis C, Seretis F, Lagoudianakis E, Politou M, Gementzis G, Salemis NS. Enhancing the accuracy of platelet to lymphocyte ratio after adjustment for large platelet count: a pilot study in breast cancer patients. Int J Surg Oncol.2012; 2012: 653608. https://doi.org/10.1155/2012/653608.
Downloads
Published
Issue
Section
License
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.