Recent data suggest that loss of BRCA1 function is associated with increased immune response, what may correlate with improved outcomes. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been proposed as indicators of systemic inflammatory response. To further explore associations between BRCA1 mutations and host immune response we assessed the prognostic value of pre-treatment NLR and PLR in patients with newly diagnosed BRCA1-associated ovarian cancer.
We conducted a retrospective analysis of medical documentation of 172 patients with newly diagnosed ovarian cancer, treated in Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch between 2008 and 2012. 94 of these patients have known BRCA mutation status (21 patients were BRCA (+) and 73 (-)). ROC curves for progression free survival PFS and overall survival (OS) prediction were plotted to verify cut-off points for NLR and PLR. PFS and OS were analysed for correlation with NLR and PLR using Cox regression model.
Among woman with BRCA1 mutation we observed significantly higher NLR (2.92 vs. 1.84; p = 0.0224) and PLR (180.98 vs. 157.21; p = 0.0072). However, there was no significant association between NLR, PLR and response to treatment (p = 0.0539 and p = 0.0851 respectively). According to univariate analysis, NLR and PLR were not prognostic for PFS and OS in BRCA1-associated ovarian cancer. In multivariate analysis NLR had no impact on PFS in OS, but higher PLR was associated with significantly shorter OS (p = 0.0378) among patients with BRCA1 mutation.
Patients with BRCA1-associated epithelial ovarian cancer have higher pre-treatment NLR and PLR values in comparison with sporadic disease. Among these patients high pre-treatment PLR was independent negative prognostic factor for OS. Due to small sample size, larger studies are warranted.
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All authors have declared no conflicts of interest.