Association between systemic immune-inflammatory biomarkers (SII, NLR, PLR, LMR) and breast cancer

• Published in: Critical Public Health
• Main Authors: Ying Wen, Yuanyuan Tang, Qiongyan Zou
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2025-12-01
• Subjects: Breast cancer; systemic immune-inflammatory index; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; lymphocyte-to-monocyte ratio
• Online Access: https://www.tandfonline.com/doi/10.1080/09581596.2025.2535091

Systemic immune-inflammatory biomarkers (SII, NLR, PLR, and LMR) have been widely recognized as indicators of chemotherapy response and predictors of cancer prognosis. However, their association with breast cancer prevalence remains insufficiently explored. Data were extracted from the 2001–2018 National Health and Nutrition Examination Survey database. Weighted multivariate logistic regression, restricted cubic spline models, subgroup analyses, and receiver operating characteristic (ROC) curve analyses were employed to evaluate the association between these biomarkers and breast cancer. A total of 20,843 women were included in this study, among whom 532 (2.55%) self-reported a diagnosis of breast cancer. SII (OR = 1.19; 95%CI: 1.02–1.39; p = 0.026), NLR (OR = 1.60; 95%CI: 1.23–2.10; p < 0.001), and PLR (OR = 1.41; 95%CI: 1.12–1.77; p = 0.003) were positively associated with breast cancer risk, while LMR (OR = 0.55; 95%CI: 0.41–0.74; p < 0.001) was negatively associated with breast cancer risk, and all were linearly correlated (P-nonlinear > 0.05). Subgroup analysis revealed that elevated SII levels were particularly associated with increased breast cancer prevalence among women aged ≥65 years. The ROC curves yielded the area under the curve (AUC) values of 0.810 (SII), 0.814 (NLR), 0.810 (PLR), and 0.812 (LMR), indicating superior efficacy in identifying breast cancer. All biomarkers demonstrated significant nonlinear associations with all-cause and cancer-specific mortality (P-nonlinear < 0.001). In conclusion, SII, NLR, PLR, and LMR are independently associated with breast cancer risk and may serve as accessible and cost-effective biomarkers for early risk stratification and longitudinal monitoring of breast cancer.