Tumor Biology

, Volume 37, Issue 7, pp 9037–9043 | Cite as

Pretreatment lymphocyte to monocyte ratio as a predictor of prognosis in patients with early-stage triple-negative breast cancer

  • Juanjuan He
  • Pengwei Lv
  • Xue Yang
  • Yanli Chen
  • Chao Liu
  • Xinguang Qiu
Original Article


Recent studies have shown that the lymphocyte to monocyte ratio (LMR) is a useful prognostic factor in various cancers. The purpose of the current study was to investigate the association between pretreatment LMR, disease-free survival (DFS), and overall survival (OS) in patients with early-stage (I to III) triple-negative breast cancer (TNBC). Pretreatment LMR with corresponding clinical features from 230 TNBC patients was noted. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimal cutoff values for LMR, lymphocyte, and monocyte counts. The difference between variables was calculated using chi-square tests. The Kaplan–Meier method and univariate and multivariate Cox regression models were applied to assess OS and DFS. Based on the ROC analysis, the optimal cutoff point for LMR was 4.7. Associations between high LMR (≥4.7) and significantly small tumor size (P = 0.005) and TNM stage (P = 0.013) were found, although there was no significant association for other clinical pathological factors. In the multivariate analysis, LMR was a significant predictive factor for both OS (hazard ratio [HR] = 0.42; 95 % confidence interval [CI], 0.19–0.95; P < 0.001) and DFS (HR = 0.40; 95 % CI, 0.20–0.79; P < 0.001). In addition, the predictive values of the OS and DFS were also observed for absolute counts of lymphocytes (P < 0.001) and monocytes (P < 0.001). Our study suggests that pretreatment LMR may be a predictive factor for long-term survival in patients with early-stage TNBC.


Triple-negative breast cancer Lymphocyte to monocyte ratio Disease-free survival Overall survival 


Compliance with ethical standards

Conflicts of interest


Supplementary material

13277_2016_4793_Fig4_ESM.gif (99 kb)
Fig. S1

Distribution of the baseline LMR (a), ALC (b) and AMC (c) in the peripheral blood of 230 patients with triple-negative breast cancer. Abbreviations: ALC, Absolute lymphocyte count; AMC, Absolute monocyte count; LMR, Lymphocyte-to-monocyte ratio (GIF 98 kb)

13277_2016_4793_MOESM1_ESM.tif (3.2 mb)
High Resolution Image (TIF 3277 kb)
13277_2016_4793_Fig5_ESM.gif (35 kb)
Fig. S2

ROC curves analyses for disease-free survival prediction were plotted to verify the optimal cut-off points for LMR (a), ALC (b), and AMC (c) (GIF 35 kb)

13277_2016_4793_MOESM2_ESM.tif (804 kb)
High Resolution Image (TIF 803 kb)
13277_2016_4793_Fig6_ESM.gif (58 kb)
Fig. S3

Kaplan–Meier survival analysis of baseline ALC and AMC in patients with triple-negative breast cancer. a, OS curve for ALC; b, DFS curve for ALC; c, OS curve for AMC; d, DFS curve for AMC. Abbreviations: ALC, absolute lymphocyte count; AMC, absolute monocyte count (GIF 58 kb)

13277_2016_4793_MOESM3_ESM.tif (2.2 mb)
High Resolution Image (TIF 2269 kb)
13277_2016_4793_MOESM4_ESM.doc (36 kb)
ESM 4 (DOC 36 kb)


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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2016

Authors and Affiliations

  • Juanjuan He
    • 1
  • Pengwei Lv
    • 1
  • Xue Yang
    • 1
  • Yanli Chen
    • 1
  • Chao Liu
    • 1
  • Xinguang Qiu
    • 2
  1. 1.Department of Breast Surgery, The First Affiliated HospitalZhengzhou UniversityZhengzhouChina
  2. 2.Department of Thyroid Surgery, The First Affiliated HospitalZhengzhou UniversityZhengzhouPeople’s Republic of China

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