Low prognostic nutritional index score is associated with lymph node metastasis in patients with breast cancer, whereas hemoglobin-albumin-lymphocyte-platelet score is not

Background Nutritional status and immune function are pivotal to the progression of cancer. The present study is designed to explore the associations between the prognostic nutritional index (PNI) score, hemoglobin-albumin-lymphocyte-platelet (HALP) score, and lymph node metastasis (LNM) in breast cancer patients. Methods A total of 799 breast cancer patients were enrolled in this retrospective study, and their clinical data were collected. The PNI and HALP score were calculated for all patients. According to the status of LNM, the patients were divided into LNM-positive patients and LNM-negative cohort. The differences in PNI and HALP score between the two groups were compared, and statistical analysis was performed to clarify the relationship between these two scores and LNM. Results 412 cases (51.6%) were confirmed with LNM, whereas the remaining 387 (48.4%) were LNM-free. The median levels of both HALP (37.9 (28.2, 46.8) vs. 42.0 (33.4, 54.6), p < 0.001) and PNI (51.2 (48.3, 53.8) vs. 52.6 (50.2, 55.3), p < 0.001) were notably lower in patients with LNM than in those without this condition. When LNM was designated as the endpoint for receiver operating characteristic (ROC) curve analysis of HALP and PNI levels, the optimal cutoff values were determined to be 39.95 for HALP and 52.45 for PNI. Logistic regression analysis showed that low PNI levels (odds ratio [OR]: 1.481, 95% confidence interval [CI]: 1.016-2.159, p = 0.041) was associated with LNM, but HALP not ( p = 0.257). Conclusions Low PNI is a potential risk factor for LNM in breast cancer. Clinically, PNI can be used as a convenient warning tool for LNM in breast cancer, and attention should be paid to nutritional and immune intervention before and after surgery.