Immune Cell Counts, Systemic Immune Inflammation Index and Pan Inflammation Immune Value in Female Nigerian Breast Cancer Patients before Treatment

Introduction: Evidences suggest that breast cancer is associated with inflammation but blood based inflammation indices previously used to support this finding were calculated using only two blood cell parameters. The present study hypothesized that alterations of blood cell based inflammatory indices could differentiate breast cancer characteristics.

Objective: Considering the importance of immune cells in tumourigenesis, the present study investigated new inflammation index (pan inflammation immune value, PIIV), systemic immune inflammation index (SII), selected immune cell counts (neutrophils, lymphocytes, basophils and eosinophils) and platelets in breast cancer patients with different clinico-pathological characteristics.

Methods: A cross-sectional case-control study conducted on breast cancer patients from Radiation Oncology Department, University College Hospital, Ibadan, Nigeria. Blood cells were counted using automation while PIIV and SII were calculated in relation with breast clinico-pathological characteristics or patient’s attributes.

Results: Most of the patients (67.4%) had monocyte counts below normal reference range. Mean total white blood cell (WBC), lymphocyte and SII were significantly increased in breast cancer patients compared with control. Mean total WBC and lymphocyte counts were significantly raised in early stage-, well-differentiated- and non-metastatic- breast cancer patients. Mean monocyte count was raised in invasive lobular-, well differentiated-, non-metastatic- and single positive- breast cancer patients. PIIV were raised in early stage-, poorly differentiated- and triple positive breast cancer patients. Mean WBC count and SII were significantly higher in obese breast cancer patients while PIIV was significantly increased in normotensive patients that were less than 40yrs old at diagnosis.

Conclusion: The study concluded that monocytes and lymphocytes are important immune cells at the early stage of breast cancer and that immune cell, SII or PIIV has differentiating potential for breast cancer characteristics.