To explore the efficacy of platelet-to-lymphocyte ratio (PLR) in predicting the response to neoadjuvant chemotherapy in breast cancer patients.

A total of 93 breast cancer patients who received neoadjuvant chemotherapy from March 2021 to February 2023 were selected. SPSS 23.0 software was used for statistical analysis. Enumeration data were described as [cases (%)] and analyzed by the χ² test. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy. Multivariate Logistic regression analysis was applied to explore the influencing factors. A two-tailed test with α=0.05 was considered statistically significant.

The ROC curve showed that the area under the curve (AUC) of PLR for predicting the response to neoadjuvant chemotherapy in breast cancer patients was 0.861 (95% CI: 0.850-0.913), with a cut-off value of 124.5, a specificity of 64.8%, and a sensitivity of 91.1%. According to the PLR cut-off value, patients were divided into the low PLR group (PLR<124.5, n=59) and the high PLR group (PLR ≥ 124.5, n=34). The proportions of clinical stageⅢ, tumor diameter>5 cm, and positive lymph node status in the high PLR group were significantly higher than those in the low PLR group (P<0.05). Univariate analysis showed that clinical stageⅢ, tumor diameter > 5 cm, PLR ≥ 124.5, and positive lymph node status were correlated with the response to neoadjuvant chemotherapy in breast cancer patients (P<0.05). Binary Logistic stepwise regression analysis revealed that tumor diameter > 5 cm, positive lymph node status, and PLR ≥ 124.5 were influencing factors for the response to neoadjuvant chemotherapy in breast cancer patients (P<0.05).

PLR can serve as an important marker for predicting the response to neoadjuvant chemotherapy in breast cancer patients. A higher PLR level is associated with a poorer response to neoadjuvant chemotherapy and a lower pathological complete response (pCR) rate.