title: Pretreatment lymphocyte to monocyte ratio as a predictor of prognosis in patients with early-stage triple-negative breast cancer.
abstract: Recent studies have shown that the lymphocyte to monocyte ratio (LMR) is a useful prognostic factor in various cancers. The purpose of the current study was to investigate the association between pretreatment LMR, disease-free survival (DFS), and overall survival (OS) in patients with early-stage (I to III) triple-negative breast cancer (TNBC). Pretreatment LMR with corresponding clinical features from 230 TNBC patients was noted. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimal cutoff values for LMR, lymphocyte, and monocyte counts. The difference between variables was calculated using chi-square tests. The Kaplan-Meier method and univariate and multivariate Cox regression models were applied to assess OS and DFS. Based on the ROC analysis, the optimal cutoff point for LMR was 4.7. Associations between high LMR (≥4.7) and significantly small tumor size (P = 0.005) and TNM stage (P = 0.013) were found, although there was no significant association for other clinical pathological factors. In the multivariate analysis, LMR was a significant predictive factor for both OS (hazard ratio [HR] = 0.42; 95 % confidence interval [CI], 0.19-0.95; P < 0.001) and DFS (HR = 0.40; 95 % CI, 0.20-0.79; P < 0.001). In addition, the predictive values of the OS and DFS were also observed for absolute counts of lymphocytes (P < 0.001) and monocytes (P < 0.001). Our study suggests that pretreatment LMR may be a predictive factor for long-term survival in patients with early-stage TNBC.
authors.affiliation: Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Juanjuan
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Pengwei
authors.initials: P
authors.lastname: Lv
authors.affiliation: Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Yanli
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Thyroid Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China. qiu1897890@126.com.
authors.forename: Xinguang
authors.initials: X
authors.lastname: Qiu
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000379:methods; D018655:Lymphocyte Count / Q000379:methods; D008214:Lymphocytes / Q000473:pathology*; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D015999:Multivariate Analysis; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000473:pathology*
keywords: Disease-free survival; Lymphocyte to monocyte ratio; Overall survival; Triple-negative breast cancer