31P - The prognostic value of pre-treatment peripheral neutrophil-lymphocyte-ratio (NLR) and its correlation with mutant p53 expression in Indonesian triple negative breast cancer patients

Background

Triple-Negative Breast Cancer (TNBC) represents an aggressive phenotype among other breast cancer subtypes with worst prognosis due to abundant inflammatory process. Recent pre-clinical study suggested a correlation between p53 inactivation and systemic inflammation response in driving breast cancer progression. In this study, we evaluated the prognostic value of pre-treatment NLR and its association with mutant p53 expression.

Methods

TNBC patients treated in of Dr. Sardjito General Hospital during 2014-2017 were retrospectively analyzed. Receiver Operating Curve (ROC) was utilized to determine the NLR cut off value and Kaplan Meier survival analysis was used to evaluate the 3-years overall survival (OS). To examine the correlation of NLR and p53, chi-square and independent t-test analysis were applied. Multivariate analysis was done using Cox Proportional Hazard Regression Model with adjustment for age, BMI, clinical staging, histological grading, subtypes, and therapy.

Results

A total of 53 TNBC patients were included in this study. The cut off value used to classify NLR into high and low NLR was 1.67 (AUC: 0.720, 95%CI: 0.581-0.859, p: 0.007, sensitivity: 87.1%, specificity: 50.0%). Mutant p53 expression was associated with high NLR (p= 0.013) with significant difference (Mean difference: 0.611, 95%CI: 0.425-1.179, student’s t-test p: 0.036). Patients with high NLR showed worse 3-years OS than patients with low NLR (Median OS±SE (months): 21.205±2.356, 95%CI: 16.588-25.823 vs unreached, p: 0.006). NLR was an independent prognostic factor of TNBC based on multivariate analysis (HR: 3.705, 95%CI: 1.176-11.666, p: 0.025).

Conclusions

Mutant p53 expression was associated with high NLR and, furthermore, NLR was an independent prognostic marker for TNBC. Therefore, this combination has the potential to stratify TNBC patients’ risk and further study is needed to formulate the stratification system.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.