Platelet-Lymphocyte Ratio in Positive Sentinel Lymph Node in Early Breast Cancer

PLR and SLNB in Early Breast Cancer
Vol. 21 No. 1 : 2026 (205-214)

Abstract
Platelets promote tumour progression, while lymphocytes are critical for cancer immune surveillance, suggesting that the platelet-to-lymphocyte ratio (PLR) may reflect malignant tumour behaviour. This is a single-centre, cross-sectional study aimed to evaluate the association between preoperative PLR and positive sentinel lymph node biopsy (SLNB) in early breast cancer. Secondary objectives included assessing the relationship between positive SLNB and clinico-pathological features. Preoperative PLR was calculated as the absolute platelet count divided by the absolute lymphocyte count, with a cut-off value of 127.1, determined by receiver operating characteristics (Area under the curve = 0.53). Statistical analysis was performed using the Pearson Chi-Square test. Among 271 women with early breast cancer who underwent SLNB, 17.7% (n = 48) had positive SLNB. No significant correlation was found between PLR and SLNB positivity (p = 0.193). However, high PLR was significantly associated with Chinese ethnicity (OR 2.524, 95% CI 1.05-6.069, p = 0.039). In conclusion, preoperative PLR does not predict SLNB positivity in early breast cancer and may not be suitable as an independent preoperative tool for assessing sentinel lymph node metastasis. Further research is required to explore alternative predictive markers.

Keywords : Breast cancer; lymphocyte; platelet; sentinel lymph node biopsy,

Correspondance Address
Syariz Ezuan Sulaiman. Department of Surgery, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6017 2775053 E-mail: alequenaezai@gmail.com


FIGURE 1: Receiver operating characteristics  (ROC) curve for platelet-to-lymphocyte ratio (PLR)