Objective: To investigate the relationship between systemic inflammatory response index (SII), serum thymidine kinase 1 (TK1), C-reactive protein/albumin (CRP/ALB) ratio and postoperative recurrence and metastasis in patients with triple negative breast cancer (TNBC). Methods: 268 TNBC patients admitted to the Affiliated Hospital of Xuzhou Medical University from January 2018 to May 2020 were selected and divided into recurrent metastasis group and non recurrent metastasis group according to whether they had recurrent metastasis 3 years after surgery. Calculated preoperative SII, CRP/ALB ratio and detected serum TK1 level. The factors of postoperative recurrence and metastasis in TNBC patients were analyzed by multivariate Logistic regression, the predictive value of SII, serum TKI and CRP/ALB ratio for postoperative recurrence and metastasis in TNBC patients was analyzed by receiver operating characteristic (ROC) curve. Results: After 3 years of follow-up, the recurrence and metastasis rate of 268 TNBC patients was 25.00% (67/268). Compared with non recurrence and metastasis group, the SII, serum TKI and CRP/ALB ratio in recurrence and metastasis group increased (P<0.05). Independent risk factors for postoperative recurrent metastasis in TNBC patients were TNM stage III, lymph node metastasis and SII, serum TKI, and an elevated CRP/ALB ratio P<0.05). The area under the curve of SII, serum TKI and CRP/ALB ratio in predicting postoperative recurrence and metastasis of TNBC patients was 0.917, which was greater than 0.789, 0.779 and 0.781 predicted by SII, serum TKI and CRP/ALB ratio alone. Conclusions: The increase of SII, serum TKI and CRP/ALB ratio are closely relate to the recurrence and metastasis of TNBC patients after operation, the combination of SII, serum TKI and CRP/ALB ratio has a high predictive value for the recurrence and metastasis of TNBC patients after operation. [ABSTRACT FROM AUTHOR]