探讨外周血中性粒细胞百分比-白蛋白比值（NPAR）与乳腺癌的关联性，并评估其对乳腺癌的临床预测效能。

选取2016年1月至12月109例乳腺恶性肿瘤患者（恶性组）、94例乳腺良性肿瘤患者（良性组），同时纳入同期100例健康女性作为对照组，检测三组研究对象外周血中性粒细胞百分比、血清白蛋白水平并计算NPAR，通过统计学方法分析组间指标差异，采用二元Logistic回归探讨NPAR与乳腺癌发病风险的相关性，利用受试者工作特征（ROC）曲线评估其诊断价值。

恶性组NPAR、中性粒细胞比值均显著高于良性组和健康组，血清白蛋白水平则显著低于后两组，三组间NPAR差异具有统计学意义（P<0.05）；恶性组中不同分子分型、腋窝淋巴结转移状态、组织学分级等临床特征亚组的NPAR比较，差异均无统计学意义（P>0.05）。多因素Logistic回归分析表明，未纳入年龄校正时，NPAR是乳腺癌发生的显著危险因素（P<0.05），但纳入年龄后其关联性消失（P=0.820），而年龄为乳腺癌的独立危险因素（OR=1.077, 95%CI: 1.043-1.113, P<0.001）；外周血中性粒细胞比值、血清白蛋白与乳腺癌发病无显著统计学关联（P均>0.05）。ROC曲线分析显示，年龄用于区分乳腺癌与乳腺良性肿瘤的AUC为0.747（95%CI: 0.680-0.815），最佳临界值为45.5岁，敏感度为61.5%，特异度为76.6%；NPAR区分乳腺癌与乳腺良性肿瘤的曲线下面积（AUC）为0.732（95%CI: 0.667-0.797），最佳临界值为11.88，敏感度75.2%，特异度61.7%；年龄、NPAR二者联合用于区分乳腺癌与乳腺良性肿瘤的AUC为0.799（95%CI: 0.739-0.859），敏感度为75.2%，特异度为74.5%。

NPAR在乳腺恶性肿瘤、良性肿瘤及健康人群中存在显著差异，未校正年龄时与乳腺癌风险相关，但其作用受年龄混杂或调节；年龄是乳腺癌明确的独立危险因素，NPAR作为乳腺癌独立风险因子的证据尚不充分。检测NPAR可辅助临床识别乳腺癌，但其临床应用价值仍需大样本、多中心研究进一步验证。

To investigate the correlation between peripheral blood neutrophil percentage-albumin ratio (NPAR) and breast cancer, and to evaluate its clinical predictive efficacy for breast cancer.

A total of 109 patients with malignant breast tumors (malignant group), 94 patients with benign breast tumors (benign group) from January to December 2016 were enrolled, and 100 healthy women during the same period were included as the control group. Peripheral blood neutrophil percentage and serum albumin level were measured in the three groups, and NPAR was calculated. Intergroup differences in the indicators were analyzed by statistical methods. Binary Logistic regression was used to explore the correlation between NPAR and the risk of breast cancer, and ROC curve was applied to assess its diagnostic value.

NPAR and neutrophil percentage in the malignant group were significantly higher than those in the benign group and healthy group, while serum albumin level was significantly lower than that in the latter two groups. The difference in NPAR among the three groups was statistically significant (P<0.05). In the malignant group, there were no statistically significant differences in NPAR among subgroups with different clinical characteristics, including molecular subtypes, axillary lymph node metastasis status, and histological grade (P>0.05). Multivariate Logistic regression analysis showed that NPAR was a significant risk factor for breast cancer before adjustment for age (P<0.05), but the correlation disappeared after age adjustment (P=0.820), whereas age was an independent risk factor for breast cancer (OR=1.077, 95%CI: 1.043-1.113, P<0.001). Peripheral blood neutrophil percentage and serum albumin showed no significant statistical correlation with the incidence of breast cancer (all P>0.05). ROC curve analysis revealed that the AUC of age for differentiating breast cancer from benign breast tumors was 0.747 (95%CI: 0.680-0.815), with an optimal cutoff value of 45.5 years, a sensitivity of 61.5% and a specificity of 76.6%. The area under the curve (AUC) of NPAR for distinguishing breast cancer from benign breast tumors was 0.732 (95%CI: 0.667-0.797), with an optimal cutoff value of 11.88, a sensitivity of 75.2% and a specificity of 61.7%. The combined use of age and NPAR for differentiating breast cancer from benign breast tumors yielded an AUC of 0.799 (95%CI: 0.739-0.859), with a sensitivity of 75.2% and a specificity of 74.5%.

NPAR differs significantly among patients with malignant breast tumors, benign breast tumors and healthy individuals. It is associated with breast cancer risk before age adjustment, but its effect is confounded or modulated by age. Age is a definite independent risk factor for breast cancer, while the evidence supporting NPAR as an independent risk factor for breast cancer is insufficient. Detection of NPAR can assist in the clinical identification of breast cancer, but its clinical application value still needs to be further verified by large-sample and multicenter studies.