Análise de malignidade de neoplasias mamárias em gatas e da relação neutrófilo/linfócito e albumina/globulina como fator prognóstico

Abstract

Inflammatory responses have been associated with tumor growth, angiogenesis, and cell survival. Blood parameters that reflect systemic inflammation, such as the neutrophil-lymphocyte ratio (NLR) and the albumin-globulin ratio (AGR), have been considered prognostic factors in both humans and dogs across various cancer types. These markers (NLR and AGR) can be measured inexpensively, easily, and rapidly prior to surgical treatment; however, they have not yet been sufficiently explored as prognostic factors in feline mammary tumors. Therefore, the objectives of this study were to select queens with mammary carcinoma and to determine the prognostic value of NLR and AGR in feline mammary tumors. Medical records of queens diagnosed with mammary carcinoma and treated at the Veterinary Hospital of UFU between January 2020 and December 2022 were retrospectively reviewed. Clinical data were collected from the records, including age, history of spaying, breed, tumor size, tumor location, clinical stage, number of tumor nodules, as well as histological type and grade. NLR was calculated from leukocyte percentages obtained through microscopic examination. AGR was obtained by subtracting albumin concentration (g/dL) from total protein, after which the albumin value (g/dL) was divided by the resulting difference. ROC curve analysis was used to determine the accuracy of NLR and AGR in predicting prognosis. Survival curves were generated using the Kaplan–Meier method, and curve comparisons were performed using the log-rank test. NLR presented an Area Under the Curve (AUC) of 0.762 [95% CI, 0.419–1.00]. The sensitivity and specificity of NLR (cut-off value 3.7) for predicting survival were 85.7% and 66.7%, respectively. The mean survival time for queens with NLR < 3.7 was 379 days, compared to 163 days for those with NLR ≥ 3.7. No significant differences were observed between the survival curves of queens with NLR < 3.7 and those with NLR ≥ 3.7 (p = 0.427). AGR showed an AUC of 0.821 [95% CI, 0.543–1.00]. The sensitivity and specificity of AGR (cut-off value 0.445) for predicting survival were 85.7% and 50%, respectively. The mean survival time for queens with AGR ≤ 0.445 was 149 days, whereas for those with AGR > 0.445 it was 403 days. No significant differences were observed between the survival curves of queens with AGR ≤ 0.445 and those with AGR > 0.445 (p = 0.116). The present study suggests that AGR may have potential preoperative prognostic utility for queens with mammary carcinoma, while the NLR showed no prognostic utility.