Tumor Biology

, Volume 37, Issue 3, pp 4135–4142 | Cite as

Elevated preoperative neutrophil-to-lymphocyte ratio predicts poor disease-free survival in Chinese women with breast cancer

  • Jin Hong
  • Yan Mao
  • Xiaosong Chen
  • Li Zhu
  • Jianrong He
  • Weiguo Chen
  • Yafen Li
  • Lin Lin
  • Xiaochun Fei
  • Kunwei Shen
Original Article


Inflammation and tumor immune microenviroment are critical factors for prognosis in numerous cancers. The aim of this study was to determine the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) in breast cancer. We performed a retrospective analysis of 487 patients diagnosed with primary breast cancer at Shanghai Ruijin hospital from January 2009 to December 2010. Hematological parameters before surgery, clinicopathological data, and survival status were obtained. Survival analysis was used to evaluate the prognostic value of NLR. The optimal cutoff value was determined as 1.93 for NLR and the median follow-up time was 55.0 months. On univariate analysis, patients with high NLR (>1.93) had worse 5-year disease-free survival (DFS) compared to those with low NLR (77.9 vs 88.0 %, p = 0.002). Regarding overall survival, there was no significant difference between patients with high NLR and low NLR, with 5-year overall survival of 90.8 and 91.7 % (p = 0.707). In triple-negative breast cancer, patients with high NLR was associated with worse 5-year DFS compared with patients with low NLR (63.4 vs 84.9 %, p = 0.040). Mutivariate analysis revealed that NLR was an independent prognostic factor for DFS in breast cancer (HR = 1.867, 95 % confidence interval; (95%CI) = 1.155–3.017, p = 0.011). Preoperative NLR is an independent predictor of DFS in breast cancer patients, especially in triple-negative subtype. Further studies are required to validate the prognostic value of NLR before clinical application.


Breast cancer Neutrophil-to-lymphocyte ratio Disease-free survival Molecular subtype 



We would like to thank all patients participating in our study. This research was supported by the grants from Technology Innovation Act Plan of Shanghai Municipal Science and Technology Commission (Grant Number: 14411950200, 14411950201).

Compliance with ethical standards

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Jin Hong
    • 1
  • Yan Mao
    • 2
  • Xiaosong Chen
    • 1
  • Li Zhu
    • 1
  • Jianrong He
    • 1
  • Weiguo Chen
    • 1
  • Yafen Li
    • 1
  • Lin Lin
    • 3
  • Xiaochun Fei
    • 4
  • Kunwei Shen
    • 1
  1. 1.Comprehensive Breast Health Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
  2. 2.Center of Diagnosis and Treatment for Breast DiseaseAffiliated hospital of Qingdao UniversityQingdaoChina
  3. 3.Department of Clinical Laboratory, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
  4. 4.Department of Pathology, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina

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