Evidence mapPaperPMID 42528994Full record

ArticleFrontiers in immunology2026

From associations to clinical practice: translating inflammatory-nutritional indices into a machine learning-driven model for breast cancer risk stratification with cross-ethnic validation.

Yue Li, Ting Ding, Xiaoyan Zhou, Chao Lu, Yue Zhang, Qian He, Jiangbo Ding

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Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Yue LiDepartment of Clinical Laboratories, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Ting DingDepartment of Clinical Laboratories, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Xiaoyan ZhouDepartment of Clinical Laboratories, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Chao LuJitang College, North China University of Science and Technology, Tangshan, China.
Yue ZhangDepartment of Clinical Laboratories, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Qian HeDepartment of Clinical Laboratories, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Jiangbo DingDepartment of Clinical Laboratories, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: To evaluate inflammatory-nutritional indices in relation to breast cancer (BC) risk and mortality and develop a cross-ethnically validated prediction model. Methods: From National Health and Nutrition Examination Survey (NHANES) 2005-2018, 485 BC patients and 16,838 female controls were included, with mortality follow-up through 2019. Weighted multivariate logistic and Cox regression assessed associations between seven inflammatory indices, two composite indicators, and BC risk/mortality. Multiple machine learning (ML) algorithms, including XGBoost, were used to construct risk models. The model was externally validated (NHANES other periods:1999-2004) and cross-ethnic validated. We prospectively enrolled Chinese treatment-naïve breast cancer patients and matched healthy controls for external validation. Results: In fully adjusted models, the Advanced Lung Cancer Inflammation Index (ALI) was inversely associated with BC risk and all-cause mortality (highest vs. lowest tertile: odds ratio [OR] 0.64, 95% CI 0.45-0.91; hazard ratio [HR] 0.41, 95% CI 0.18-0.90). Conversely, neutrophil percentage-to-albumin ratio (NPAR), systemic inflammation response index (SIRI), and neutrophil-to-lymphocyte ratio (NLR) showed positive associations. ALI outperformed other indices in predicting mortality. XGBoost identified NPAR as the top predictive feature; the model incorporating inflammatory indices and age achieved an AUC of 0.832 on the test set, and a web-based dynamic nomogram incorporating these factors was developed. External validation yielded AUCs of 0.781 (NHANES) and 0.730 (Chinese cohort). Conclusions: ALI (protective) and NPAR/SIRI/NLR (detrimental) are robust predictors of BC risk and mortality. The ML model demonstrates good predictive performance, but cross-ethnic validation highlights the need for population-specific calibration, which indicated the potential of ML approaches leveraging inflammatory-nutritional indices to enhance BC risk stratification and inform clinical decision-making.

Indexed as

Breast NeoplasmsInflammationMachine LearningNutritional StatusAdultAgedBoosting Machine Learning AlgorithmsCase-Control StudiesChinaFemaleHumansMiddle AgedNeutrophilsNutrition SurveysPredictive Learning ModelsProspective Studiesbreast cancerinflammation statusmachine learningnutritionrisk stratification

Identifiers

PMID42528994
PMCPMC13416066

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.