Bahri ÖZER, Oğuz ÇATAL, Songül PELTEK ÖZER, Fatih KEYİF, Mustafa ŞİT, Nuri KAMA

Complete Blood Count parameters could predict malignancy in breast lesions

Aim: Inflammatory response plays an important role in the development and progression of various cancers, including breast cancer.The aim of present study is determining Complete Blood Count parameters as possible predictors of malignancy in breast lesions.Material and Methods: Patients with BI-RADS-4 breast disease were studied between 2010 and 2017 retrospectively. Patients withlesions detected radiologically were included in the study. According to the histopathological results, the study cohort was dividedinto two groups, either benign or malignant. Final blood counts of the patients before pre-biopsy were evaluated in preoperativeperipheral blood measurements. When blood was taken, care was taken not to have other causes of leukocytosis in the patient.Complete Blood Count parameters were compared in these groups.Results: A total of 331 women with BI-RADS 4 lesions enrolled to the study. Mortality and morbidity were not observed after breastbiopsy in patients. Platelet (p=0.04), platelet to lymphocyte ratio (p=0.006) and red cell distribution width to platelet ratio (p=0.032)values of the patients with BI RADS 4A were found significantly different in the malignant group compared to benign BI RADS 4Agroup. In total BIRADS 4 lesions, the ratio of PLT and RPR was significant in malignant group (p=0.047, p=0.002) in Complete BloodCount parameters compared benign and malignant group.Conclusion: Studies have shown that cancer affects peripheral blood cells positively or negatively. In our study, among peripheralblood cells, platelets were found to be the most affected in cancer patients. The PLT, PLR and RPR values could be valuable inpredicting malignant BIRADS 4 breast lesions.

PDF

___

1. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature 454:436–44.
2. Colotta F, Allavena P, Sica A, et al. Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability. Carcinog 2009;30:1073-81.
3. Mantovani A, Romero P, Palucka AK, et al. Tumour immunity: effector response to tumour and role of the microenvironment. Lancet 2008;371:771-83.
4. Hanahan D, Weinberg RA. Hallmarks of cancer: The Next Generation. Cell 2011;144:646-74.
5. Elverici E, Barça AN, Aktaş H, et al. Nonpalpable BI-RADS 4 breast lesions: sonographic findings and pathology correlation. Diagn and Interv Radiol 2015;21:189.
6. DeSantis C, Ma J, Bryan L, et al. Breast cancer statistics, 2013. CA Cancer J Clin 2014;64:52-62.
7. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet 2001;357:539-45.
8. Schreiber RD, Old LJ, Smyth MJ. Cancer immunoediting: integrating immunity’s roles in cancer suppression and promotion. Science 2011;331:1565-70.
9. Lee Y, Kim SH, Han J-Y, et al. Early neutrophil-tolymphocyte ratio reduction as a surrogate marker of prognosis in never smokers with advanced lung adenocarcinoma receiving gefitinib or standard chemotherapy as first-line therapy. J Cancer Res Clin Oncol 2012;138:2009-16.
10. Lee WS, Park YL, Kim N, et al. Myeloid cell leukemia-1 is associated with tumor progression by inhibiting apoptosis and enhancing angiogenesis in colorectal cancer. AM J Cancer Res 2015;5:101.
11. Li X, Han Z, Cheng Z, et al. Preoperative neutrophilto-lymphocyte ratio is a predictor of recurrence following thermal ablation for recurrent hepatocellular carcinoma: a retrospective analysis. PLOS ONE 2014;9:e110546.
12. Pinato DJ, Mauri FA, Ramakrishnan R, et al. Inflammation-based prognostic indices in malignant pleural mesothelioma. J Thorac Oncol 2012;7:587-94.
13. Jiang X, Wang Y, Su Z, et al. Red blood cell distribution width to platelet ratio levels in assessment of histologic severity in patients with primary biliary cholangitis. Scand J Clin Lab Invest 2018;78:258-63.
14. Xie S, Chen X. Red blood cell distribution width-toplatelet ratio as a disease activity-associated factor in systemic lupus erythematosus. Medicine (Baltimore) 2018;97:12342.
15. Atak BM, Erkus E, Duman TT, et al. Mean Platelet volume to platelet and red cell distribution width to platelet ratios in Irritable Bowel Syndrome. Exp Biomed Res 2018;1:60-3.
16. Howlander N, Noone A, Krapcho M, et al. SEER cancer statistics review, 1975–2009 (vintage 2009 populations). Bethesda, MD: Natl Cancer Inst 2012.
17. Brown KM, Domin C, Aranha GV, et al. Increased preoperative platelet count is associated with decreased survival after resection for adenocarcinoma of the pancreas. Am J Surg 2005;189:278-82.
18. Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014;106: dju124.