The clinical value of the combined detection of circulating low-density neutrophils and inflammatory markers in breast cancer with lymph node metastasis

Q: Why are circulating low-density neutrophils (LDNs) investigated in breast cancer?

LDNs are associated with cancer-related, tumor-supportive roles and can reflect inflammatory and immunologic conditions relevant to disease progression.

Q: How were LDNs and inflammatory indicators measured and analyzed?

Peripheral blood samples were analyzed by flow cytometry to measure LDN levels, followed by variable selection with Lasso logistic regression and univariate/multivariate logistic regression to identify independent risk factors.

Q: What does the study conclude about diagnosing or identifying lymph node metastasis?

LDNs levels may serve as potential biomarkers for breast cancer progression, and a combined nomogram incorporating LDNs and other hematological inflammatory indicators shows potential for identifying patients with lymph node metastasis.

Sep 22, 2026

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Breast cancer remains the leading cancer in women, and axillary lymph node metastasis and distant spread are central prognostic determinants. Circulating low-density neutrophils (LDNs) are linked to tumor-supporting biology, motivating evaluation of whether combining LDNs with hematological inflammatory indicators improves risk assessment in breast cancer patients with lymph node metastasis. Peripheral blood was analyzed by flow cytometry, and predictive modeling was developed and validated for clinical applicability.

LanguageEnglish

CategoryHealthcare

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Pages14

Reading Time35 min

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Abstract

Introduction

Methods

Results

Conclusion

Mo etal. BMC Cancer (2026) 26:1061 BMC Cancer [https://doi.org/10.1186/s12885-026-16384-6](https://doi.org/10.1186/s12885-026-16384-6) RESEARCH Open Access The clinical value of the combined detection of circulating low ⁃ density neutrophils and inflammatory markers in breast cancer with lymph node metastasis Dongping Mo1*, Cong Li1, Xuelian Mao1, Lijun Zheng1,2 and Feng Yan1* Abstract Background Breast cancer (BC) is the most prevalent cancer in women globally, with axillary lymph node metastasis (LNM) and distant metastasis being key prognostic factors linked to survival. Circulating low-density neutrophils (LDNs) in cancer patients are associated with tumor-supportive role. This study assessed the clinical relevance of combining circulating LDNs with hematological indicators in BC patients with LNM. Methods Peripheral blood samples from 184 BC patients were analyzed using flow cytometry to measure the LDNs levels. Lasso logistic regression was used for variable selection, and univariate and multivariate logistic regression identified independent risk factors. A predictive nomogram was developed and validated with an external cohort. Results LDNs were elevated in BC patients, especially those with LNM. Seven variables—LDNs, CEA, CA153, PLR, SIRI, NMLR, and NHR—were identified for further analysis. Multivariate logistic regression identified five of these as independent risk factors for LNM: LDNs (OR = 2 . 307, P = 0 . 032), CEA (OR = 4 . 027, P < 0. 001), CA153 (OR = 2 .440, P = 0 . 016), PLR (OR = 2 . 563, P = 0 . 014), and SIRI (OR = 4 . 617, P = 0 . 003) . The nomogram model based on these factors demonstrated good predictive performance with an optimism-corrected C-statistic of 0 . 780, consistent in the external validation set (AUC = 0 . 762) . The calibration curve confirmed good clinical applicability. Conclusion This study suggests circulating LDNs levels may be potential biomarkers for BC progression, and anomogram combing LDNs with other hematological indicators shows potential for identifying patients with LNM. Keywords Low ⁃ density neutrophils, Inflammatory markers, Lymph node metastasis, Breast cancer, Nomogram model *Correspondence: Dongping Mo[moxiaoyubang@163.com](moxiaoyubang@163.com)[ ](moxiaoyubang@163.com)Feng Yan [yanfeng@jszlyy.com.cn](yanfeng@jszlyy.com.cn) 1Department of Clinical Laboratory, Jiangsu Cancer Hospital & Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, Jiangsu 210009, People’s Republic of China 2Department of Clinical Laboratory, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, People’s Republic of China © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Mo et al. BMC Cancer (2026) 26:1061 Introduction Breast cancer is the most common cancer among women, representing about 23.8% of new cases and 15.4% of female cancer deaths [1]. Lymph node status is crucial for determining the stage, grade, treatment, and prognosis of breast cancer, with sentinel lymph node (SLN) status guidin

FAQs

Why are circulating low-density neutrophils (LDNs) investigated in breast cancer?

LDNs are associated with cancer-related, tumor-supportive roles and can reflect inflammatory and immunologic conditions relevant to disease progression.

How were LDNs and inflammatory indicators measured and analyzed?

Peripheral blood samples were analyzed by flow cytometry to measure LDN levels, followed by variable selection with Lasso logistic regression and univariate/multivariate logistic regression to identify independent risk factors.

What does the study conclude about diagnosing or identifying lymph node metastasis?

LDNs levels may serve as potential biomarkers for breast cancer progression, and a combined nomogram incorporating LDNs and other hematological inflammatory indicators shows potential for identifying patients with lymph node metastasis.

Sep 22, 2026

Upload by CatatanPagi