Correlation of Peripheral Neutrophil-to-Lymphocyte Ratio (NLR) with Ki-67 and Other Clinicopathological Parameters of Breast Carcinoma.

Ki-67 is a protein expressed in the nucleus of cells during different phases of the cell cycle. Higher levels of Ki-67 expression in breast cancer are associated with high proliferation and poor prognosis. Neutrophil-to-lymphocyte ratio (NLR) is a peripheral marker of inflammation, an elevated pretreatment NLR is associated with an increased risk of relapse and worse survival among breast cancer patients. The present study was a retrospective and prospective study conducted on 140 patients under which the presurgical neutrophil-lymphocyte ratio was correlated with histological subtype, grade, stage, molecular subtype, and Ki-67 proliferation index in patients with breast carcinoma. There was a significant association between Ki67 expression groups and NLR ratio as well as between molecular subtypes groups and NLR ratio (p < 0.001). However, no significant association was found between Nottingham Bloom Richardson (NBR) grades and tumor size, nodal status, and metastasis (TNM) stages with NLR ratio (p > 0.001). NLR is a low-cost, minimally invasive, personal, and reliable marker of inflammation which has potential utility in predicting short- and long-term prognosis and risk stratification for anti-inflammatory or immune therapy for cancer patients in the future.