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Association between the platelet to lymphocyte ratio, neutrophil to lymphocyte ratio and axillary lymph node metastasis in cT1N0 breast cancer patients.

OBJECTIVE
To investigate the relationship between platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and axillary lymph node metastasis in cT1N0 breast cancer patients.


METHODS
The clinicopathological data of 154 patients with cT1N0 breast cancer from January 2015 to June 2020 were retrospectively analyzed. All patients underwent sentinel lymph node (SLN) biopsy. The differences of PLR and NLR levels among groups with different clinicopathological factors (age, tumor size, ER, PR, HER-2, Ki67, p53 expression levels, vascular tumor thrombus and SLN metastasis) were compared. The relationship between clinicopathological factors and metastasis of SLN and non-SLN was analyzed.


RESULTS
There were 32 patients with SLN metastasis. The cut-off values of PLR and NLR for the whole group were 142.91 and 2.84. The PLR level was higher in patients with vascular tumor thrombus and SLN metastasis (P<0.05), and the NLR level was higher in patients with P53 negative and SLN metastasis groups (P<0.05). According to univariate analysis, there were significant differences in SLN metastasis among different tumor sizes, vascular tumor thrombus states, PLR and NLR levels (P<0.05), but there was no significant difference in SLN metastasis among patients with different ages, ER, PR, HER-2, Ki67, p53 expression groups (P>0.05). According to multivariate analysis, the risk of SLN metastasis in patients with vascular tumor thrombus was higher than that in patients without vascular tumor thrombus (P<0.05). The risk of SLN metastasis in patients with high level of PLR was higher than that in patients with low level of PLR (P<0.05). The difference was not significant in SLN metastasis status among patients with different ages and ER, PR, HER-2, Ki67, p53 expression and NLR level (P>0.05).


CONCLUSION
High level of PLR and vascular tumor thrombus are the risk factors for SLN metastasis.