الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In Egypt, BC is the most prevalent malignancy in women, accounting for 38.8% of cancers, in spite of the advances in treatment, it remains a common cause of cancer deaths in women.
Recently, multiple studies demonstrate the importance of the host immunological and inflammatory responses in the tumor’s microenvironment for the initiation and spread of cancer. It is now obvious that tumor characteristics do not entirely predict the prognosis of cancer patients. Researchers have demonstrated that patients with a variety of malignancies may estimate their chance of survival using the pretreatment index or the systemic inflammation score.
The study aims to assess whether NLR and/or PLR could act as prognostic factors to overall survival and disease free survival in non-metastatic breast cancer in all molecular sub types.
We retrospectively assessed 348 female non metastatic breast cancer patients who were diagnosed and treated by surgery and chemotherapy therapy during the period from January 2012- December 2019. the medical record were reviewed and data extracted. NLR was calculated by the ratio between the absolute count of neutrophils and the absolute count of lymphocytes. PLR was calculated by dividing the absolute number of platelets by the absolute number of lymphocytes.
Cut of value calculated using ROC curve. The ratio closest to the point with maximum sensitivity and specificity was defined as the optimal cutoff value. As a result, the optimal cutoff value was 1.65 for the NLR and, 125.52 for the PLR.
Statistical analysis of the results revealed that high NLR significantly associated with worse overall survival (P=0.039) and with a lower DFS (P=0.038). But this is not for PLR, a non-significant association with OS and DFS was found. Moreover, high NLR associated with adverse parameters such as large tumor size > 5cm.
Although the PLR did not completely reach the predetermined threshold for statistical significance with overall survival and disease free survival, it was found that the combined NLR/PLR were significant as prognostic for both OS (P=0.031) and DFS (P=0.029).
However, both inflammatory blood marker NLR and PLR failed to show any statistical significant results in neoadjuvent setting to predict pCR (P=0.907), (P=0.197) correspondingly.