Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 7;71(6):e20250067.
doi: 10.1590/1806-9282.20250067. eCollection 2025.

The prognostic value of platelet count and lymphocyte-to-monocyte ratio, Ki-67, and Nottingham indexes in early-stage breast cancer

Aysu Okumuş  1 , Hüseyin Döngelli  1 , Hüseyin Salih Semiz  2 , Merve Keskinkılıç  2 , Buket Hamitoğlu  2 , Tuğba Yavuzşen  2
Affiliations

The prognostic value of platelet count and lymphocyte-to-monocyte ratio, Ki-67, and Nottingham indexes in early-stage breast cancer

Aysu Okumuş et al. Rev Assoc Med Bras (1992). .

Abstract

Objective: The Nottingham Prognostic Index, Ki-67 Prognostic Index, and combination of platelet count and lymphocyte-to-monocyte ratio have shown prognostic significance in breast cancer. This aim of the study was to compare combination of platelet count and lymphocyte-to-monocyte ratio with Nottingham Prognostic Index and Ki-67 Prognostic Index in early-stage breast cancer.

Methods: A retrospective cohort study included 321 women aged ≥18 years diagnosed with early-stage breast cancer (2010-2020) who did not receive neoadjuvant chemotherapy. Data were extracted from records, with laboratory values collected preoperatively, postoperatively, and at 6-month and 1-year intervals. Regression and survival analyses evaluated the predictive value of combination of platelet count and lymphocyte-to-monocyte ratio, Nottingham Prognostic Index, and Ki-67 Prognostic Index for disease-free survival and overall survival.

Results: The mean age at diagnosis was 53.3 years. The mortality rate was 6.2%, and recurrence occurred in 9.3% of patients. Univariate regression showed age as the sole factor influencing overall survival (HR 1.063, p<0.001). Factors associated with disease-free survival included Luminal-B subtype (HR 3.790, p=0.029), estrogen receptor negativity (HR 15.710, p=0.007), human epidermal growth factor receptor 2 positivity (HR 4.833, p<0.001), Nottingham Prognostic Index (HR 1.967, p=0.009), and Ki-67 Prognostic Index stage (HR 1.908, p=0.008). Multivariate analysis identified age as the only significant predictor for overall survival, while human epidermal growth factor receptor 2-negativity was the sole independent factor for disease-free survival.

Conclusion: Combination of platelet count and lymphocyte-to-monocyte ratio did not show significant prognostic value in early-stage hormone receptor-positive breast cancer. However, Nottingham Prognostic Index and Ki-67 Prognostic Index were strong predictors, particularly for disease-free survival.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: the authors declare there is no conflicts of interest.

References

    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021 [published correction appears in CA Cancer J Clin. 2021;71(4):359. https://doi.org/10.3322/caac.21669] CA Cancer J Clin. 2021;71(1):7–33. doi: 10.3322/caac.21654. - DOI - DOI - PubMed
    1. Rivas FWS, Gonçalves R, Mota BS, Sorpreso ICE, Toporcov TN, Filassi JR, et al. Comprehensive diagnosis of advanced-stage breast cancer: exploring detection methods, molecular subtypes, and demographic influences - A cross-sectional study. Clinics (Sao Paulo) 2024;;79:100510–100510. doi: 10.1016/j.clinsp.2024.100510. - DOI - PMC - PubMed
    1. Joo S, Ko ES, Kwon S, Jeon E, Jung H, Kim JY, et al. Multimodal deep learning models for the prediction of pathologic response to neoadjuvant chemotherapy in breast cancer. Sci Rep. 2021;11(1):18800–18800. doi: 10.1038/s41598-021-98408-8. - DOI - PMC - PubMed
    1. Nobrega GB, Mota BS, Freitas GB, Maesaka JY, Mota RMS, Goncalves R, et al. Locally advanced breast cancer: breast-conserving surgery and other factors linked to overall survival after neoadjuvant treatment. Front Oncol. 2023;;13:1293288–1293288. doi: 10.3389/fonc.2023.1293288. - DOI - PMC - PubMed
    1. Pardi PC, Turri JAO, Bayer LHCM, Nóbrega GB, Filassi JR, Simões RDS, et al. Biological action of melatonin on target receptors in breast cancer. Rev Assoc Med Bras (1992) 2024;70(3):e20231260. doi: 10.1590/1806-9282.20231260. - DOI - PMC - PubMed