Article Abstract

Clinical implication of platelet-lymphocyte ratio and PD-L1 in breast cancer patients

Authors: Qianyi Lu, Tao Qin, Fei Xu, Yinduo Zeng, Wen Xia, Qiufan Zheng, Kaping Lee, Kai Zhang, Ge Qin, Man Tek Kong, Ruoxi Hong, Yanxia Shi, Zhongyu Yuan, Shusen Wang

Abstract

Background: The anti-tumor action of the host immune systems and cancer-immune interaction are associated with tumor prognosis. Combination of neutrophil-lymphocyte ratio (NLR)/platelet-lymphocyte ratio (PLR) and programmed death ligand-1 (PD-L1) in predicting prognosis in breast cancer has not been reported. The aim of this study is to evaluate the prognostic role of NLR/PLR and PD-L1 in breast cancer.
Methods: A total of 870 patients with breast cancer treated in Sun Yat-sen University Cancer Center from 2000 to 2012 with known PD-L1 status were included. Clinicopathological data and pretreatment complete blood count (CBC) were retrospectively collected. Chi-square test and Mann-Whitney U test were used to compare baseline characteristics, Kaplan-Meier and univariate Cox proportional hazards model analyses were used to compare the survival of patients between different groups.
Results: High PLR group achieved worse result than low PLR group in overall survival (OS) and disease-free survival (DFS) (5-year OS rate: 82.6% vs. 88.8%, P=0.010; 5-year DFS rate: 78.7% vs. 85.6%, P=0.003). High PLR was associated with shorter DFS [adjusted HR =1.525, 95% confidence interval (CI): 1.111–2.094, P=0.009] and OS (adjusted HR =1.527, 95% CI: 1.073–2.174, P=0.019). NLR was not associated with patients’ survival outcome. Patients with PD-L1 expression and high PLR had the worst prognosis. The 5-year DFS rates were 68.4%, and 85.8% in high PLR + PD-L1(+) group and low PLR + PD-L1(−) group respectively (P=0.002). The 5-year OS rates were 73.4% and 90.1%, respectively (P<0.001).
Conclusions: High PLR is associated with poor DFS and OS in breast cancer patients. PD-L1 expression combined with high PLR was associated with an aggressive clinical outcome. Further studies are needed to evaluate the predictive value of the combination of PD-L1 and peripheral blood immune markers.