Platelet-Lymphocyte Ratio in Positive Sentinel Lymph Node in Early Breast Cancer
PLR and SLNB in Early Breast Cancer
Abstract
Platelets promote tumour progression, while lymphocytes are critical for cancer immune surveillance, suggesting that the platelet-to-lymphocyte ratio (PLR) may reflect malignant tumour behaviour. This is a single-centre, cross-sectional study aimed to evaluate the association between preoperative PLR and positive sentinel lymph node biopsy (SLNB) in early breast cancer. Secondary objectives included assessing the relationship between positive SLNB and clinico-pathological features. Preoperative PLR was calculated as the absolute platelet count divided by the absolute lymphocyte count, with a cut-off value of 127.1, determined by receiver operating characteristics (Area under the curve = 0.53). Statistical analysis was performed using the Pearson Chi-Square test. Among 271 women with early breast cancer who underwent SLNB, 17.7% (n = 48) had positive SLNB. No significant correlation was found between PLR and SLNB positivity (p = 0.193). However, high PLR was significantly associated with Chinese ethnicity (OR 2.524, 95% CI 1.05-6.069, p = 0.039). In conclusion, preoperative PLR does not predict SLNB positivity in early breast cancer and may not be suitable as an independent preoperative tool for assessing sentinel lymph node metastasis. Further research is required to explore alternative predictive markers.
Keywords :
Breast cancer; lymphocyte; platelet; sentinel lymph node biopsy,
Abstrak
Platelet berperanan dalam menggalakkan perkembangan tumor, manakala limfosit penting untuk pengawasan imun terhadap kanser, menunjukkan bahawa nisbah platelet kepada limfosit (PLR) berpotensi meramalkan tingkah laku tumor malignan. Kajian keratan rentas di satu pusat ini dijalankan untuk menilai hubungan antara PLR prapembedahan dan keputusan positif biopsi nodus limfa sentinel (SLNB) dalam kanser payudara awal. Objektif sekunder kajian ini adalah untuk menilai hubungan antara SLNB positif dengan ciri-ciri klinikopatologi. PLR prapembedahan dikira berdasarkan nisbah antara jumlah platelet mutlak dengan jumlah limfosit mutlak, menggunakan nilai ambang 127.1 yang ditentukan melalui ciri operasi penerima (Luas di bawah lengkung = 0.53). Analisis statistik dilakukan menggunakan ujian Chi-Square Pearson. Dalam kalangan 271 wanita dengan kanser payudara peringkat awal yang menjalani SLNB, sebanyak 17.7% (n = 48) mempunyai SLNB positif. Tiada korelasi yang signifikan ditemui antara PLR dan SLNB positif (p = 0.193). Namun begitu, PLR yang tinggi menunjukkan hubungan signifikan dengan etnik Cina (OR 2.524, 95% CI 1.05-6.069, p = 0.039). Kesimpulannya, PLR prapembedahan tidak dapat meramalkan keputusan positif SLNB dalam kanser payudara peringkat awal dan mungkin tidak sesuasi digunakan sebagai parameter prapembedahan untuk menilai metastasis nodus limfa sentinel. Kajian lanjut diperlukan untuk mengkaji penanda ramalan alternatif.
Kata Kunci :
Biopsi nodus limfa sentinel; kanser payudara; limfosit; platelet,
Correspondance Address
Syariz Ezuan Sulaiman. Department of Surgery, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Tel: +6017 2775053 E-mail: alequenaezai@gmail.com
