Abstract 32P
Background
Ki-67 a cellular proliferation marker is used in breast cancer (BC) to guide therapy decision and predict prognosis in some clinical cases. It could signify treatment responsiveness/ resistance before, during and after neoadjuvant therapy. However, despite having potential applicability Ki-67 has still not been completely integrated as a standard point of care tool in clinical decision making or routine pathological reporting. Neutrophil to lymphocyte ratio (NLR) has emerged as a potential prognostic factor in various cancers, including breast cancer. Neutrophil: Lymphocyte roughly translates as tumor: immunity and this ratio in fact becomes more significant with polarization state of neutrophils and recognition of pro-tumor N2 neutrophils.
Methods
73 histopathologically diagnosed cases of BC were included in this study, their pre-treatment NLR was noted and Ki-67 expression graded. NLR was calculated from 2 ml peripheral blood as a ratio of absolute neutrophil count to absolute lymphocyte count and was categorized as low < 3 or high ≥ 3. Ki-67 immunohistochemistry was visually graded as low ≤ 5%, intermediate 6-29% and high ≥ 30%. Various clinical and histopathological characteristics of these patients were also noted. Statistical tests were performed using SPSS version 25.0, p value of < 0.05 was taken as significant.
Results
The Ki-67 immunoexpression showed a statistically significant correlation (p < 0.05) with tumor grade (modified SBR grading), tumor size, lymph node status, and clinical stage. Correlation of NLR with tumor SBR grade turned out to be non-significant (p > 0.05), however, NLR showed a statistically significant correlation with tumor size, lymph node status, and clinical stage (p< 0.05). Amongst themselves, the peripheral NLR and tumor Ki-67 immunoexpression showed a statistically significant correlation (p< 0.05).
Conclusions
The tumor proliferative potential and its subsequent therapeutic and prognostic implications as deducted from the Ki-67 index could very well be signified by peripheral NLR. Baseline NLR and its dynamics in relation to breast tumor biology could serve as a minimally invasive personalized marker for early diagnosis, guiding therapy, prognosis and follow-up in clinical settings.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.