A Clinical Study to Evaluate the Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Libyan Women with Breast Cancer

Abtisam Miftah Dhaw; Omro A. Aburas; Emhamed Boras; Najwa Zargani; Mostafa Abdoarrahem

doi:10.33214/7d3b6135

Authors

Abtisam Miftah Dhaw Higher Institute of Science and Medical Technology, Pharmacy Department, Tripoli /Abusalim. Author
Omro A. Aburas Higher Institute of Science and Medical Technology, Pharmacy Department, Tripoli /Abusalim. Author
Emhamed Boras Libyan Academy of postgraduate Studies, Life Science Department, Tripoli/ Janzor Author
Najwa Zargani Higher Institute of Science and Medical Technology, Pharmacy Department, Tripoli /Abusalim. Author
Mostafa Abdoarrahem Libyan Academy of postgraduate Studies, Life Science Department, Tripoli/ Janzor Author

DOI:

https://doi.org/10.33214/7d3b6135

Keywords:

Brest cancer, Neutrophil, Lymphocyte, Neutrophil-to-Lymphocyte ratio (NLR).

Abstract

Background: Cancer has emerged as one of the most pressing health challenges of the 21st century, surpassing many infectious and chronic diseases in its global impact. While multiple environmental, genetic, and lifestyle-related factors can contribute to cancer development, the efficiency of the immune system plays a pivotal role in preventing it. Breast cancer is one of the most common malignancies affecting women, representing a major challenge in early diagnosis and prognosis. Despite the remarkable advances achieved in diagnostic techniques, there remains a pressing need for simple, reliable, and cost-effective biomarkers that can enhance clinical assessment and support treatment decision-making. Objective: The aim of this study that the research seeks to analyze the predictive value of the neutrophil-to-lymphocyte ratio (NLR) as a simple and accessible biomarker that could be utilized in the clinical assessment of breast cancer patients. Methods: This study is a prospective descriptive investigation designed to raise awareness about cancers and their underlying causes, with a particular emphasis on immune-inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR). The primary aim was to assess the predictive and diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) in cancer patients using real patient data. Results: The analysis revealed a high prevalence of elevated neutrophil-to-lymphocyte ratio (NLR) (>3) across the sample. This elevation was particularly associated with advanced stages of cancer and with older age groups (>50 years). Patients younger than 30 years exhibited exclusively normal neutrophil-to-lymphocyte ratio (NLR) values. These findings reinforce the prognostic role of neutrophil-to-lymphocyte ratio (NLR) as a low-cost and clinically valuable biomarker. Conclusion: The present study evaluated the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in Libyan breast cancer patients. The findings demonstrated that the majority of patients (80%) had elevated neutrophil-to-lymphocyte ratio (NLR) values (>3), with higher prevalence observed in advanced cancer stages and in older age groups. These results strongly support the role of neutrophil-to-lymphocyte ratio (NLR) as a biomarker of systemic inflammation and cancer progression.

REFERENCES

Chen, C., Cong, B. L., Wang, M., Abdullah, M., Wang, X. L., Zhang, Y. H., Xu, S. J., & Cui, L. (2018). Neutrophil to lymphocyte ratio as a predictor of myocardial damage and cardiac dysfunction in acute coronary syndrome patients. Integrative medicine research, 7(2), 192–199.

Chen, F., Chen, D., Jin, L., Xu, C., Zhao, W., & Hu, W. (2022). Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and C-Reactive Protein/Albumin Ratio in Luminal Breast Cancers With HER2-Negativity. Frontiers in oncology, 12, 845935.

Chen, J., Deng, Q., Pan, Y., He, B., Ying, H., Sun, H., Liu, X., & Wang, S. (2015). Prognostic value of neutrophil-to-lymphocyte ratio in breast cancer. FEBS open bio, 5, 502–507.

Ethier, J. L., Desautels, D., Templeton, A., Shah, P. S., & Amir, E. (2017). Prognostic role of neutrophil-to-lymphocyte ratio in breast cancer: a systematic review and meta-analysis. Breast cancer research : BCR, 19(1), 2.

Faria, S. S., Fernandes, P. C., Jr, Silva, M. J., Lima, V. C., Fontes, W., Freitas-Junior, R., Eterovic, A. K., & Forget, P. (2016). The neutrophil-to-lymphocyte ratio: a narrative review. Ecancermedicalscience, 10, 702.

Fridman, W. H., Pagès, F., Sautès-Fridman, C., & Galon, J. (2012). The immune contexture in human tumours: impact on clinical outcome. Nature reviews. Cancer, 12(4), 298–306.

Gong, P., Liu, Y., Gong, Y., Chen, G., Zhang, X., Wang, S., Zhou, F., Duan, R., Chen, W., Huang, T., Wang, M., Deng, Q., Shi, H., Zhou, J., Jiang, T., & Zhang, Y. (2021). The association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio with post-thrombolysis early neurological outcomes in patients with acute ischemic stroke. Journal of neuroinflammation, 18(1), 51.

Grassadonia, A., Graziano, V., Iezzi, L., Vici, P., Barba, M., Pizzuti, L., Cicero, G., Krasniqi, E., Mazzotta, M., Marinelli, D., Amodio, A., Natoli, C., & Tinari, N. (2021). Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting. Cells, 10(7), 1685.

Islam, M. M., Satici, M. O., & Eroglu, S. E. (2024). Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: An extensive literature review. Turkish journal of emergency medicine, 24(1), 8–19.

Ivars Rubio, A., Yúfera, J.C., de la Morena, P., Fernández Sánchez, A., Navarro Manzano, E., García Garre, E., García Martínez, E., Marín Zafra, G., Sánchez Cánovas, M., Garcia Torralba, E., & Ayala de la Peña, F. (2019). Neutrophil-lymphocyte ratio in metastatic breast cancer is not an independent predictor of survival, but depends on other variables. Scientific Reports, 9.

Katsura, C., Ogunmwonyi, I., Kankam, H. K., & Saha, S. (2022). Breast cancer: presentation, investigation and management. British journal of hospital medicine (London, England : 2005), 83(2), 1–7.

Kim, K. M., Choi, H. S., Noh, H., Cho, I. J., Lim, S. T., Lee, J. I., & Han, A. (2021). Neutrophil to Lymphocyte Ratio after Treatment Completion as a Potential Predictor of Survival in Patients with Triple-Negative Breast Cancer. Journal of breast cancer, 24(5), 443–454.

Koh, C. H., Bhoo-Pathy, N., Ng, K. L., Jabir, R. S., Tan, G. H., See, M. H., Jamaris, S., & Taib, N. A. (2015). Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. British journal of cancer, 113(1), 150–158.

Li, J., Wang, X., Jia, W., Wang, K., Wang, W., Diao, W., Ou, F., Ma, J., & Yang, Y. (2024). Association of the systemic immuno-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio with diabetic microvascular complications. Frontiers in endocrinology, 15, 1367376.

Liu, J. K. H., Irvine, A. F., Jones, R. L., & Samson, A. (2022). Immunotherapies for hepatocellular carcinoma. Cancer medicine, 11(3), 571–591.

Nemoto, D., Yokose, T., Katayama, K., Murakami, S., Kato, T., Saito, H., Suzuki, M., Eriguchi, D., Samejima, J., Nagashima, T., Ito, H., Yamada, K., Nakayama, H., & Masuda, M. (2021). Tissue surface area and tumor cell count affect the success rate of the Oncomine Dx Target Test in the analysis of biopsy tissue samples. Thoracic cancer, 12(2), 194–200.

Pistelli, M., De Lisa, M., Ballatore, Z., Caramanti, M., Pagliacci, A., Battelli, N., Ridolfi, F., Santoni, M., Maccaroni, E., Bracci, R., Santinelli, A., Biscotti, T., Berardi, R., & Cascinu, S. (2015). Pre-treatment neutrophil to lymphocyte ratio may be a useful tool in predicting survival in early triple negative breast cancer patients. BMC cancer, 15, 195.

Templeton, A. J., McNamara, M. G., Šeruga, B., Vera-Badillo, F. E., Aneja, P., Ocaña, A., Leibowitz-Amit, R., Sonpavde, G., Knox, J. J., Tran, B., Tannock, I. F., & Amir, E. (2014). Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Journal of the National Cancer Institute, 106(6), dju124.

Zhang, W., Tan, Y., Li, Y., & Liu, J. (2023). Neutrophil to Lymphocyte ratio as a predictor for immune-related adverse events in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis. Frontiers in immunology, 14, 1234142