Association between the neutrophil percentage-to-albumin ratio and breast cancer risk: Evidence from the National Health and Nutrition Examination Survey 1999-2016

Abstract

Background: Increasing evidence underscores the association between chronic inflammation and carcinogenesis. Aim: The aim of the study is to investigate the association between the neutrophil percentage-to-albumin ratio (NPAR) and breast cancer (BC) risk. Methods: This analysis utilized cross-sectional data from 16,993 participants enrolled in the National Health and Nutrition Examination Survey from 1999 to 2016. To investigate the link between NPAR and BC risk, weighted multivariate logistic regression models were applied. Nonlinear associations were explored using restricted cubic spline (RCS) models. Furthermore, a nomogram incorporating NPAR was constructed for risk stratification, and its predictive accuracy was evaluated using receiver operating characteristic curve (ROC) analysis. Results: After adjusting for potential confounders, elevated NPAR levels showed a significant positive association with BC (odds ratio [OR] = 1.12, 95% confidence interval [95% CI]: 1.08-1.16; p<0.001). Compared with the reference quartile (Q1), progressively increasing ORs associated with BC were observed across ascending NPAR quartiles: Q1: OR 1.05 (95% CI: 0.78-1.42), Q2: OR 1.35 (95% CI: 1.02-1.79), and Q3: OR 1.47 (95% CI: 1.12-1.93). Analysis using RCS indicated a linear relationship where increasing NPAR levels were associated with a higher risk of BC. The predictive model incorporating NPAR demonstrated strong accuracy for BC prediction, achieving an area under the ROC curve of 0.8068 (95% CI: 0.7904-0.8232). Conclusion:Our findings reveal a significant dose-dependent association between NPAR and BC risk in a nationally representative sample from the United States. Although cross-sectional designs preclude causal inference, longitudinal studies should validate these observations and explore underlying biological mechanisms. Relevance for patients: NPAR could potentially serve as a novel biomarker to predict BC risk in patients.

Keywords

National Health and Nutrition Examination Survey / Neutrophil percentage-to-albumin ratio / Breast cancer / Inflammatory marker

Funding

This study was supported by the Henan Provincial Medical Science and Technology Research Plan (Joint Construction Projects, Grant Numbers: LHGJ20200957 and LHGJ20210911), issued by the Henan Provincial Health Commission (Yu Wei Ke Jiao Han [2021] No. 1 and No. 39).

Conflict of interest

The authors declare that they have no competing interests.

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