MEME KANSERI ALT TIPLERI ILE SERUM INFLAMATUAR BELIRTEÇLERI ARASINDAKI ILIŞKININ DEĞERLENDIRILMESI

Yıl 2023, Cilt: 3 Sayı: 3, 1 - 6, 22.12.2023

Zeliha Türkyılmaz , Tuğrul Demirel

https://doi.org/10.58961/hmj.1338535

Öz

Amaç: Meme kanseri kadınlarda en sık görülen kanserdir. Meme kanserinin, luminal A, luminal B, cerbB2'den zengin tip, triple negatif moleküler subtipleri tanımlanmıştır. Bu çalışma moleküler subtipler ile enflamatuar belirteçler arasındaki ilişkiyi ortayı koymayı amaçlamıştır.
Gereç ve Yöntemler: Ocak 2019 ve Nisan 2023 tarihleri arasında opere edilen meme kanseri hastaları değerlendirmeye alındı. Hastaların demografik özellikleri, patoji değerlendirmeleri, moleküler alt tipleri ve labaratuvar verileri toplandı. Hemogramdan Nötrofil/Lenfosit oranı (NLR), Trombosit/Lenfosit oranı (PLR) ve Sistemik Enflamatuvar Yanıt İndeksi (SIRI) hesaplandı. Moleküler alt tipler ile enflamatuar belirteçler arasında ilişki istatistiksel olarak değerlendirildi.
Bulgular: Çalışmaya dahil edilen hastaların ortanca yaşı 56 idi. Hastaların %82,8'inde östrojen reseptörü (ER+), %61,3'ünde progesteron reseptörü (PR+) pozitif çıktı. En yaygın moleküler alt tip lümen A idi. Ki67 kesme değeri 14 olduğunda ER durumu arasında istatistiksel olarak anlamlı bir ilişki bulundu (p=0,047). Ki67 cut-off değeri 20 olarak alındığında hem ER ile (p=0,002), hem de PR ile istatistiksel olarak anlamlı ilişki (p=0,025) gözlendi. NLR ve PLR'nin ortanca değerleri sırasıyla 1,9 (aralık, 0,7:21,3) ve 123 (aralık, 53,3:252) idi.
Sonuç: Meme kanseri alt tipleri ile inflamatuar belirteçler arasında anlamlı bir ilişki bulamadık. Ancak cerbB2 ile PLR ve SIRI arasında istatistiksel olarak anlamlı fark gösterme eğilimi dikkat çekiciydi (sırasıyla p=0.08, p=0.057).

Anahtar Kelimeler

Meme kanseri, Nötrofil lenfosit oranı, Trombosit lenfosit oranı, SIRI, Ki67

Evaluation of the Relationship Between Breast Cancer Subtypes and Serum Inflammatory Markers

Öz

Introduction: Breast cancer is the most common cancer in women. Luminal A, luminal B, cerbB2 enriched type , Triple negative molecular subtypes have been defined. This study aimed to reveal the relationship between molecular subtypes and inflammatory markers.
Material and Methods: Breast cancer patients who were operated between January 2019 and April 2023 were evaluated. Demographic characteristics, pathology assessments, molecular subtypes and laboratory data of the patients were collected. Neutrophil/Lymphocyte ratio (NLR), Platelet/Lymphocyte ratio (PLR) and Systemic Inflammatory Response Index (SIRI) were calculated from the hemogram. The relationship between molecular subtypes and inflammatory markers was statistically evaluated.
Results: The median age of the patients included in the study was 56 years. Among the patients, 82.8% tested positive for estrogen receptor (ER+), while 61.3% tested positive for progesterone receptor (PR+). The most common molecular subtype was luminal A. When the cut-off value for Ki67 was 14, a statistically significant correlation was found between ER status (p=0.047). When Ki67 cut-off value was set to 20, a statistically significant relationship was observed with ER (p=0.002) and a statistically significant relationship with PR (p=0.025). Median values of NLR and PLR were 1.9 (range, 0.7:21.3) and 123 (range, 53.3:252), respectively.
Conclusions: We did not find a significant relationship between breast cancer subtypes and inflammatory markers. However, the tendency to show a statistically significant difference between cerbB2 and PLR and SIRI was remarkable (p=0.08, p=0.057, respectively).

Anahtar Kelimeler

Breast cancer, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio, Systemic Inflammatory Response Index, Ki67

Kaynakça

• 1. Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, et al. Breast cancer statistics 2022. CA Cancer J Clin. 2022;72(6):524-541. DOI:10.3322/caac.21754. PMID:35020204
• 2. Guo W, Lu X, Liu Q, Zhang T, Li P, Qiao W, et al. Prognostic value of neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio for breast cancer patients: An updated meta‐analysis of 17079 individuals. Cancer med, 2019;8(9), 4135-4148. DOI:10.1002/cam4.2281. PMID:31197958
• 3. Masood S. Prognostic/predictive factors in breast cancer. Clin Lab Med. 2005;25(4):809. DOI:10.1016/j.cll.2005.08.012. PMID:16308094
• 4. Yersal O, Barutca S. Biological subtypes of breast cancer: Prognostic and therapeutic implications. World J Clin Oncol. 2014;10:5(3):412-24. DOI:10.5306/wjco.v5.i3.412. PMID:25114856
• 5. Fragomeni SM, Sciallis A, Jeruss JS. Molecular subtypes and local-regional control of breast cancer. Surg Oncol Clin N Am. 2018;27(1):95-120. DOI:10.1016/j.soc.2017.08.005. PMID:29132568
• 6. Liu Z, Zhang XS, Zhang S. Breast tumor subgroups reveal diverse clinical prognostic power. Sci Rep. 2014;6(4):4002. DOI:10.1038/srep04002. PMID: 24499868
• 7. Faria SS, Fernandes PC Jr, Silva MJ, Lima VC, Fontes W, Freitas-Junior R, et al. The neutrophil-to-lymphocyte ratio: a narrative review. Ecancermedicalscience. 2016; 12(10):702. DOI:10.3332/ecancer.2016.702. PMID:28105073
• 8. Chen L, Kong X, Wang Z, Wang X, Fang Y, Wang J. Pretreatment systemic inflammation response index in patients with breast cancer treated with neoadjuvant chemotherapy as a useful prognostic indicator. Cancer Manag Res. 2020;12:1543-1567. DOI:10.2147/CMAR.S235519. PMID:32184659.
• 9. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013;88(1):218-30. DOI:10.1016/j.critrevonc.2013.03.010. PMID: 23602134
• 10. Yersal Ö, Çetinkünar S, Aktimur R, Aziret M, Özdaş S, Erdem H, Yildirim K. Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios are not Different among Breast Cancer Subtypes. Asian Pac J Cancer Prev, 2017; 18(8):2227-2231. DOI:10.22034/APJCP.2017.18.8.2227. PMID: 28843260
• 11. Wulaningsih W, Holmberg L, Garmo H, Malmstrom H, Lambe M, Hammar N, et al. Prediagnostic serum inflammatory markers in relation to breast cancer risk, severity at diagnosis and survival in breast cancer patients. Carcinogenesis. 2015; 36(10):1121-8. DOI:10.1093/carcin/bgv096. PMID:26130675
• 12. Cheang MC, Chia SK, Voduc D, Gao D, Leung S, Snider J, et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst. 2009;101(10):736-50. DOI:10.1093/jnci/djp082. PMID:19436038
• 13. Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010;6(1):149-63. DOI:10.2217/fon.09.136. PMID:20021215
• 14. Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother, 2009;58(1):15-23. DOI:10.1007/s00262-008-0516-3. PMID:18414853
• 15. Galdiero MR, Bonavita E, Barajon I, Garlanda C, Mantovani A, Jaillon S. Tumor associated macrophages and neutrophils in cancer. Immunobiology. 2013;218(11):1402-10. DOI:10.1016/j.imbio.2013.06.003. PMID: 23891329
• 16. Hua X, Long ZQ, Huang X, Deng JP, Wen W, He ZY, Guo L, Zhang WW, Lin HX. The preoperative systemic inflammation response index (SIRI) independently predicts survival in postmenopausal women with breast cancer. Curr Probl Cancer. 2020;44(4):100560. DOI:10.1016/j.currproblcancer.2020.100560. PMID:32122667
• 17. Ethier JL, Desautels D, Templeton A, Shah PS, Amir E. Prognostic role of neutrophil-to-lymphocyte ratio in breast cancer: a systematic review and meta-analysis. Breast Cancer Res. 2017;19(1):2. DOI:10.1186/s13058-016-0794-1. PMID:28057046
• 18. Koh CH, Bhoo-Pathy N, Ng KL, Jabir RS, Tan GH, See MH, et al. Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. Br J Cancer. 2015;113(1):150-8. DOI:10.1038/bjc.2015.183. PMID:26022929
• 19. Azab B, Shah N, Radbel J, Tan P, Bhatt V, Vonfrolio S, et al. Pretreatment neutrophil/lymphocyte ratio is superior to platelet/lymphocyte ratio as a predictor of long-term mortality in breast cancer patients. Med Oncol. 2013;30(1):432. DOI:10.1007/s12032-012-0432-4. PMID:23283648
• 20. Wang L, Zhou Y, Xia S, Lu L, Dai T, Li A, et al. Prognostic value of the systemic inflammation response index (SIRI) before and after surgery in operable breast cancer patients. Cancer Biomark, 2020;28(4):537-547. DOI:10.3233/CBM-201682. PMID:32568185