目的 探讨控制营养状态（CONUT）评分在乳腺癌患者术后复发转移中的预测价值。 方法 回顾性收集于2013年4月至 2019年8月南通大学附属如皋医院接受手术治疗的168例乳腺癌患者的临床病理特征与生存随访数据，根据患者术前外周血淋巴 细胞计数、血清白蛋白及总胆固醇水平，计算CONUT评分。以3分为CONUT评分的临界值，将所有患者分为CONUT≥3分组与CO⁃ NUT<3分组。通过χ２检验评估CONUT评分与乳腺癌患者临床病理参数的关系，绘制Kaplan⁃Meier曲线，并通过单、多因素Cox回 归分析评估CONUT评分在乳腺癌患者中的预后价值。 结果 肿瘤T分期（χ２=6.666，P=0.036）及淋巴结转移（χ２= 4.562，P=0.033） 可能是CONUT≥3分乳腺癌者的影响因素。Kaplan⁃Meier曲线表明，CONUT≥3分者术后复发转移风险明显高于CONUT<3分者，5 年无复发生存率分别为78.6%与96.0%，差异有统计学意义（χ２=11.562, P=0.001）。亚组分析进一步表明，无论是TNM Ⅰ~Ⅱ期（5 年无复发生存率: 82.6% 比 96.3%；χ２ = 4.424，P=0.035）还是Ⅲ期（5年无复发生存率: 40.9% 比 89.1%，χ２ = 9.103，P=0.003），CO⁃ NUT ≥3分均提示患者预后不佳。多因素 Cox 回归显示，T 分期（HR=3.875，95%CI=1.080～13.903，P=0.038）、淋巴结转移（HR= 3.354，95%CI= 1.166～9.645，P=0.025）及CONUT评分（HR=3.003，95%CI=1.168~7.720, P=0.022）是乳腺癌患者术后复发转移的独 立预测因素。 结论 术前CONUT评分是预测乳腺癌患者术后复发转移的一项重要指标。

Objective To investigate the predictive value of controlled nutritional status (CONUT) for tumor recurrence and metastasis of breast cancer patients. Method The clinicopathological features and survival follow⁃up data of 168 breast cancer patients who underwent surgical resection in Rugao People􀆳s hospital from April 2013 to August 2019 were retrospectively collected. CONUT score was calculated based on the lymphocyte count in the peripheral blood, preoperative serum albumin and total cholesterol levels. All patients were divided into high CONUT (≥3 points) and low CONUT (<3 points) based on the preoperative CONUT score. Chi square test was used to evaluate the relationship between CONUT score and clinicopathological features of breast cancer patients. Kaplan⁃Meier curves were plotted, and the univariate and multivariate Cox regression analysis were conducted to investigate the prognostic value of CONUT score for breast cancer patients. Result High CONUT (≥3 points) was significantly associated with advanced T stage (χ２= 6.666, P=0.036) and lymph node metastasis(χ２ = 4.562, P=0.033). Kaplan⁃Meier curves showed that breast cancer patients with CONUT ≥3 had a higher risk of recurrence and metastasis than those with CONUT <3, and the 5⁃year recurrence⁃free survival (RFS) of the two groups was 78.6% and 96.0%, respectively (χ２=11.562, P=0.001). Subgroup analysis further demonstrated that CONUT ≥3 was markedly correlated to poor RFS of breast cancer patients, regardless of TNM Ⅰ-Ⅱ (5⁃year RFS: 82.6% vs 96.3%; χ２= 4.424, P=0.035) and stage Ⅲ (5⁃year RFS: 40.9% vs 89.1%; χ２= 9.103, P=0.003). The results of univariate and multivariate analysis revealed that T stage (HR=3.875, 95%CI=1.080-13.903, P=0.038), lymph node metastasis (HR=3.354, 95%CI=1.166-9.645, P=0.025) and CONUT (HR=3.003, 95%CI=1.168-7.720, P=0.022) were independent predictors of recurrence and metastasis in breast cancer patients. Conclusion CONUT could be used as an useful predictor of recurrence and metastasis in breast cancer patients.