@MASTERSTHESIS{ 2025:1255904073,
 	title = {Leukocyte ratios predict metastasis, recurrence, and mortality in breast cancer patients receiving cytotoxic chemotherapy},
 	year = {2025},
 	url = "https://tede.unioeste.br/handle/tede/7707",
 	abstract = "Breast cancer is a leading cause of female mortality worldwide. The dynamics of the 
 immune system, reflected in leukocyte-derived hematologic ratios, have been 
 increasingly recognized for their prognostic value in cancer patients. This study 
 aimed to evaluate the clinical significance of leukocyte-based hematologic ratios in 
 breast cancer patients undergoing cytotoxic polychemotherapy, focusing on their 
 association with prognosis, chemoresistance, recurrence, metastasis, and death. A 
 mixed-method observational study was conducted with 185 breast cancer patients 
 undergoing AC-T chemotherapy. Hematologic ratios, including neutrophil-to lymphocyte ratios (NLR), monocyte-to-lymphocyte ratios (MLR), and platelet-to lymphocyte ratios (PLR), were calculated at multiple treatment time points (D0–
 D168) and correlated with clinical outcomes. Statistical analyses included ANOVA, 
 ROC curve, and chi-square test to determine the prognostic accuracy of these 
 markers. Significant changes in hematologic ratios were observed during 
 chemotherapy. An increase in MLR correlated with intermediate risk of death and 
 metastasis, whereas elevated PLR and platelet-to-neutrophil ratio (PNR) were 
 strongly associated with metastasis, recurrence, and mortality. Decreases in 
 lymphocyte-to-platelet ratio (LPR) were linked to chemoresistance and adverse 
 outcomes. Leukocyte-based hematologic ratios offer valuable insights into immune 
 dynamics and prognosis in breast cancer patients undergoing chemotherapy. Their 
 integration into routine clinical assessments may improve risk stratification and 
 personalized treatment approaches.",
 	publisher = {Universidade Estadual do Oeste do Paraná},
 	scholl = {Programa de Pós-Graduação em Ciências Aplicadas à Saúde},
 	note = {Centro de Ciências da Saúde}
}