Lamiss Mohamed Sad, Ayman Elsaka, Yomna Zamzam and Walid Ahmed Almorsy
Introduction: Local inflammatory markers have been defined as prognostic and predictive markers in triple negative markers as proved by many studies. The
prognostic and predictive value of systemic inflammatory markers such as neutrophil lymphocyte ratio (NLR) and lymphocyte monocyte ratio (LMR) remain to
be elucidated.
Aim of study: To evaluate pathological complete response (PCR) to neoadjuvant chemotherapy in locally advanced cancer breast in relation to tumor infiltrating
lymphocytes(TILs), neutrophil lymphocyte ratio and lymphocyte monocyte ratio as well as overall survival and disease free survival. Patients and methods: In
Tanta university Hospital, oncology department form January 2012 to December 2013, 67 patients with locally advanced TNBC stage IIB, IIIB 0r IIIC using TNM
8th edition. All patients received neoadjuvant chemotherapy in the form of dose dense AC followed by paclitaxel (adriamycin and cyclophosphamide 60 mgm/
m2 and 600 mgm/m2 respectively the cycle is repeated every 2 weeks for 4 cycles followed by paclitaxel 175mgm/m2 every 2 weeks for 4 cycles). All cycles with
G-CSF support. Pretreatment TILs, NLR and LMR were evaluated with PCR and as prognostic factor of survival. Results: Low NLR has been detected in 74.6%
of cases and has been associated with high TILs and this was statistically significant (p value=0.03). High LMR was observed in 80.6% of cases and correlated
significantly with TILs (p value=0.003). Pathological CR was found to be associated with high TILs, low NLR and high LMR. In our study we evaluated the pre
neoadjuvant systemic and local inflammatory markers as prognostic marker we found that in multivariate analysis, the lymphocyte monocyte ratio maintained
their statistical significance with overall survival. While tumor infiltrating lymphocyte maintained their statistical significance as prognostic factors with overall
survival and disease free survival. Conclusion: Systemic inflammatory markers can be used as marker of pathological complete response in locally advanced
triple negative breast6 cancer with neoadjuvant chemothe.
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Journal of Oncology Translational Research received 93 citations as per Google Scholar report
