The prognostic value of platelet count and lymphocyte-to-monocyte ratio, Ki-67, and Nottingham indexes in early-stage breast cancer

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Okumuş A., Döngelli H., Semiz H. S., Keskinkılıç M., Hamitoğlu B., Yavuzşen T.

Revista da Associação Médica Brasileira, cilt.71, sa.6, ss.1-6, 2025 (SCI-Expanded)

• Yayın Türü: Makale / Tam Makale
• Cilt numarası: 71 Sayı: 6
• Basım Tarihi: 2025
• Doi Numarası: 10.1590/1806-9282.20250067
• Dergi Adı: Revista da Associação Médica Brasileira
• Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
• Sayfa Sayıları: ss.1-6
• Dokuz Eylül Üniversitesi Adresli: Evet

Özet

SUMMARY

OBJECTIVE:  The Nottingham Prognostic Index, Ki-67 Prognostic Index, and combination of platelet count and lymphocyte-to-monocyte ratio have shown prognostic significance in breast cancer. This aim of the study was to compare combination of platelet count and lymphocyte-to-monocyte ratio with Nottingham Prognostic Index and Ki-67 Prognostic Index in early-stage breast cancer.

METHODS:  A retrospective cohort study included 321 women aged ≥18 years diagnosed with early-stage breast cancer (2010–2020) who did not receive neoadjuvant chemotherapy. Data were extracted from records, with laboratory values collected preoperatively, postoperatively, and at 6-month and 1-year intervals. Regression and survival analyses evaluated the predictive value of combination of platelet count and lymphocyte-to-monocyte ratio, Nottingham Prognostic Index, and Ki-67 Prognostic Index for disease-free survival and overall survival.

RESULTS:  The mean age at diagnosis was 53.3 years. The mortality rate was 6.2%, and recurrence occurred in 9.3% of patients. Univariate regression showed age as the sole factor influencing overall survival (HR 1.063, p<0.001). Factors associated with disease-free survival included Luminal-B subtype (HR 3.790, p=0.029), estrogen receptor negativity (HR 15.710, p=0.007), human epidermal growth factor receptor 2 positivity (HR 4.833, p<0.001), Nottingham Prognostic Index (HR 1.967, p=0.009), and Ki-67 Prognostic Index stage (HR 1.908, p=0.008). Multivariate analysis identified age as the only significant predictor for overall survival, while human epidermal growth factor receptor 2-negativity was the sole independent factor for disease-free survival.

CONCLUSION:  Combination of platelet count and lymphocyte-to-monocyte ratio did not show significant prognostic value in early-stage hormone receptor-positive breast cancer. However, Nottingham Prognostic Index and Ki-67 Prognostic Index were strong predictors, particularly for disease-free survival.

KEYWORDS:
Breast neoplasms; Hematologic tests; Prognosis; Biomarkers; Tumor; Receptors; Estrogen