Incorporation of NLR measurements into clinical practice

Oct 13, 2025 by wbrum.org 92 views

The Role of Neutrophyl-to-Lymphocyte Ratio (NLR) as a Predictor Factor of the Presence of Far Metastasis in Breast Cancer in H. Adam Malik Hospital Medan

Introduction

Breast cancer is one of the most common types of cancer that has a significant mortality rate in Indonesia, ranking fifth as the cause of death. With a high prevalence, it is estimated that approximately 6% or equivalent to 13.2 million people in Indonesia are diagnosed with breast cancer. Research conducted at the Adam Malik Medan Hajj Center General Hospital aims to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and far metastasis events in breast cancer patients. This study was conducted with a cross-sectional method of 124 breast cancer patients treated at H. Adam Malik Hospital from February to April 2019.

The Importance of Neutrophyl-to-Lymphocyte Ratio (NLR)

Neutrophil-to-lymphocyte ratio (NLR) is a parameter that measures the ratio between the number of neutrophils and lymphocytes in the blood. Neutrophils are white blood cells that play a role in the body's immune response to infections and inflammation, while lymphocytes function in the adaptive immune system. The high NLR ratio indicates the presence of systemic inflammatory conditions that can contribute to the development of cancer. Infiltration of immune cells such as neutrophils into tumor tissue is often associated with cancer progression and metastasis development. Neutrophils can stimulate angiogenesis (the formation of new blood vessels) and produce growth factors that accelerate tumor growth. On the other hand, lower lymphocyte populations in this ratio can show the compromise of the immune system, which can benefit the growth of cancer cells.

Analysis of NLR and Metastasis Distance

The study conducted at H. Adam Malik Hospital Medan found a significant relationship between NLR values and remote metastasis events, with chi test results showing p <0.001. This result is also colored with an odds ratio (OR) of 5.9, which shows that breast cancer patients with NLR values higher than 3 have the risk of having metastasis far almost 6 times greater than patients with lower NLRs. This study highlights the importance of NLR measurements as a prognostic indicator to predict the possibility of far metastasis in breast cancer patients.

Research Relevance

This study highlights the importance of NLR measurements as a prognostic indicator to predict the possibility of far metastasis in breast cancer patients. With a better understanding of the relationship between NLR and Metastasis, doctors can take more steps in planning therapy and patient management. As an indicator that is easily measured and accessible, NLR can be a valuable tool in clinical practice. Overall, the results of the study at H. Adam Malik Medan Hospital provided further evidence of the significance of NLR in the context of breast cancer, as well as promoting awareness of the importance of inflammatory management in cancer treatment.

Conclusion

Given the high prevalence of breast cancer in Indonesia, it is essential for medical personnel to consider NLR as one of the factors in the evaluation and management of patients. This study provides further evidence of the significance of NLR in the context of breast cancer and highlights the importance of inflammatory management in cancer treatment. Further research is needed to confirm the findings of this study and to explore the potential of NLR as a prognostic indicator in other types of cancer.

Recommendations

Based on the findings of this study, the following recommendations are made:

Incorporation of NLR measurements into clinical practice: NLR measurements should be incorporated into clinical practice as a prognostic indicator to predict the possibility of far metastasis in breast cancer patients.
Further research: Further research is needed to confirm the findings of this study and to explore the potential of NLR as a prognostic indicator in other types of cancer.
Awareness of the importance of inflammatory management: Awareness of the importance of inflammatory management in cancer treatment should be promoted among medical personnel and patients.

Limitations

This study has several limitations, including:

Small sample size: The sample size of this study was relatively small, which may limit the generalizability of the findings.
Cross-sectional design: The study was conducted using a cross-sectional design, which may not capture the temporal relationship between NLR and metastasis.
Limited control for confounding variables: The study did not control for confounding variables that may affect the relationship between NLR and metastasis.

Future Directions

Future studies should aim to:

Confirm the findings of this study: Further research is needed to confirm the findings of this study and to explore the potential of NLR as a prognostic indicator in other types of cancer.
Explore the potential of NLR as a prognostic indicator in other types of cancer: NLR may have potential as a prognostic indicator in other types of cancer, and further research is needed to explore this potential.
Develop a more comprehensive understanding of the relationship between NLR and metastasis: A more comprehensive understanding of the relationship between NLR and metastasis is needed to inform clinical practice and to develop effective treatment strategies.
Frequently Asked Questions (FAQs) about Neutrophyl-to-Lymphocyte Ratio (NLR) and Breast Cancer

Q: What is Neutrophyl-to-Lymphocyte Ratio (NLR)?

A: Neutrophyl-to-Lymphocyte Ratio (NLR) is a parameter that measures the ratio between the number of neutrophils and lymphocytes in the blood. Neutrophils are white blood cells that play a role in the body's immune response to infections and inflammation, while lymphocytes function in the adaptive immune system.

Q: What is the significance of NLR in breast cancer?

A: The high NLR ratio indicates the presence of systemic inflammatory conditions that can contribute to the development of cancer. Infiltration of immune cells such as neutrophils into tumor tissue is often associated with cancer progression and metastasis development.

Q: What is the relationship between NLR and metastasis in breast cancer?

A: The study conducted at H. Adam Malik Hospital Medan found a significant relationship between NLR values and remote metastasis events, with chi test results showing p <0.001. This result is also colored with an odds ratio (OR) of 5.9, which shows that breast cancer patients with NLR values higher than 3 have the risk of having metastasis far almost 6 times greater than patients with lower NLRs.

Q: How can NLR measurements be used in clinical practice?

A: NLR measurements can be used as a prognostic indicator to predict the possibility of far metastasis in breast cancer patients. With a better understanding of the relationship between NLR and Metastasis, doctors can take more steps in planning therapy and patient management.

Q: What are the limitations of this study?

A: This study has several limitations, including:

Small sample size: The sample size of this study was relatively small, which may limit the generalizability of the findings.
Cross-sectional design: The study was conducted using a cross-sectional design, which may not capture the temporal relationship between NLR and metastasis.
Limited control for confounding variables: The study did not control for confounding variables that may affect the relationship between NLR and metastasis.

Q: What are the future directions for research on NLR and breast cancer?

A: Future studies should aim to:

Confirm the findings of this study: Further research is needed to confirm the findings of this study and to explore the potential of NLR as a prognostic indicator in other types of cancer.
Explore the potential of NLR as a prognostic indicator in other types of cancer: NLR may have potential as a prognostic indicator in other types of cancer, and further research is needed to explore this potential.
Develop a more comprehensive understanding of the relationship between NLR and metastasis: A more comprehensive understanding of the relationship between NLR and metastasis is needed to inform clinical practice and to develop effective treatment strategies.

Q: What are the implications of this study for clinical practice?

A: The findings of this study have implications for clinical practice, including:

Incorporation of NLR measurements into clinical practice: NLR measurements should be incorporated into clinical practice as a prognostic indicator to predict the possibility of far metastasis in breast cancer patients.
Awareness of the importance of inflammatory management: Awareness of the importance of inflammatory management in cancer treatment should be promoted among medical personnel and patients.

Q: What are the potential benefits of using NLR as a prognostic indicator in breast cancer?

A: The potential benefits of using NLR as a prognostic indicator in breast cancer include:

Improved patient outcomes: By identifying patients at high risk of metastasis, doctors can take more steps in planning therapy and patient management.
Personalized medicine: NLR can be used to tailor treatment strategies to individual patients based on their risk of metastasis.
Reduced healthcare costs: By identifying patients at high risk of metastasis, doctors can reduce healthcare costs by avoiding unnecessary treatments and interventions.