Relationship Between the Neutrophil to Lymphocyte Ratio, Stromal Tumor-infiltrating Lymphocytes, and the Prognosis and Response to Neoadjuvant Chemotherapy in Triple-negative Breast Cancer

The correlation between stromal tumor-infiltrating lymphocytes (sTILs) and neutrophil to lymphocyte ratio (NLR) and the impact of NLR and sTILs on the prognosis and response to neoadjuvant chemotherapy in patients with triple-negative breast cancer were studied. Through statistical analyses, NLR and sTILs were found to be independent predictors of disease-free survival, but there was no correlation between the 2. Introduction: Neutrophil to lymphocyte ratio (NLR) and stromal tumor-infiltrating lymphocytes (sTILs) are correlated with triple-negative breast cancer (TNBC) patient prognosis. However, there has been insufficient research regarding the relationship between systemic and local inflammatory states in patients with TNBC, and their effects on neoadjuvant chemotherapy (NAC) efficacy. Methods: The clinical data of 395 patients with TNBC admitted from January 2010 to December 2018 were collected. The Pearson chi(2) test was used to analyze correlations between clinical basic pathological features, NLR, sTILs, and pathological complete response (pCR). Kaplan-Meier and Cox analyses were performed to address which clinical parameters were prognostic factors of disease-free survival (DFS). Results: There was no correlation between NLR1 (baseline NLR) and sTILs (P >.05) in these patients with TNBC. Patients with TNBC with lower NLR3 (baseline NLR of patients receiving NAC) or higher sTILs scores had better pCR rates, but this failed to reach statistical significance (P>.05). Cox analysis showed that NLR1 and sTILs were independent prognostic indicators of DFS outcome in patients with TNBC (P<.01). Conclusion: In patients with TNBC, low NLR1 and high sTILs are associated with prolonged DFS. However, the link between systemic and local inflammation markers needs further exploration. (C) 2021 Elsevier Inc. All rights reserved.