Platelet count, platelet lymphocyte ratio, and Ki67 as a predictive factor of neoadjuvant chemotherapy response in locally advanced breast cancer

Abstract

Link of Video Abstract: https://youtu.be/CjzggoIFnTU   Background: Locally advanced breast cancer (LABC) is a term that refers to advanced non metastatic stage breast cancer. Neoadjuvant chemotherapy is one of the therapies given to patients with LABC. Many factors can affect the chemotherapy response, platelets produce growth factors, and cytokines promote angiogenesis and tumor growth. Inflammatory biomarkers such as platelet lymphocyte ratio (PLR) may indicate tumor progressiveness. The Ki67 proliferation index is a marker of the aggressiveness or growth of tumor cells. This study aimed to determine the correlation of platelet count, platelet lymphocyte ratio and Ki67 proliferation index before chemotherapy with neoadjuvant chemotherapy response. Method: This research used the cohort retrospective design method. A sample of 155 patients was selected using a simple random sampling technique. The inclusion criteria of this research are having complete data about pre-treatment platelet, lymphocyte platelet ratio, Ki67 and the neoadjuvant chemotherapy response result assessed by the oncologist that is written in the medical record. Patient data from other types of cancer, chronic, systemic or autoimmune diseases are excluded from this research. The data of each variable was analyzed with the Spearman correlation test. Result: There was no correlation between platelet count and neoadjuvant chemotherapy response (p=0.301). There was a negative correlation between the platelet lymphocyte ratio (p=0.026) and the Ki67 index (p=0.040) with neoadjuvant chemotherapy response. Conclusion: Based on this study, it can be concluded that platelet count is not significant in relation to chemotherapy responses. The higher the platelet lymphocyte ratio and the proliferation index of Ki67, the lower the response to neoadjuvant chemotherapy.