Prognostic significance of hemoglobin, albumin, lymphocyte, and platelet (HALP) score in breast cancer: a propensity score-matching study.

IF 5.3 2区医学 Q1 ONCOLOGY Cancer Cell International Pub Date : 2024-07-02 DOI:10.1186/s12935-024-03419-w

Tongchao Jiang, Haishuang Sun, Shuyu Xue, Tiankai Xu, Wen Xia, Ying Wang, Ling Guo, Huanxin Lin

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Abstract

Background: The hemoglobin-albumin-lymphocyte-platelet (HALP) score functions as a comprehensive index that assesses the systemic inflammatory response, nutritional, and immune status. This study aimed to explore the relationship between preoperative HALP score and the prognosis of BC patients and to develop predictive nomograms.

Methods: Clinicopathological data were collected for BC patients who underwent mastectomy between December 2010 and April 2014 from Sun Yat-sen University Cancer Center. The optimal cutoff value for HALP was determined by maximally selected rank statistics for overall survival data. Propensity score matching (PSM) was applied to develop comparable cohorts of high-HALP group and low-HALP group. Kaplan-Meier curves and Cox regression analyses were performed to determine the impact of HALP on BC patients. Prognostic nomograms were developed based on the multivariate Cox regression method. Then, the concordance index (C-index), calibration plots, and decision curves analysis (DCA) were applied to evaluate the prognostic performance of the nomograms.

Results: A total of 1,856 patients were included as the primary cohort, and 1,470 patients were matched and considered as the PSM cohort. In the primary cohort, the 5-year overall survival (OS) and progression-free survival (PFS) rates for high-HALP group (≥ 47.89) and low-HALP group (< 47.89) were 94.4% vs. 91.0% (P = 0.005) and 87.8% vs. 82.1% (P = 0.005), respectively. Similar results were observed in PSM cohort (5-year OS, 94.3% vs. 90.8%, P = 0.015; 5-year PFS, 87.5% vs. 83.2%, P = 0.036). Notably, multivariate Cox regression analysis in the PSM cohort showed that HALP could independently predict BC patient prognosis in both OS (HR: 0.596, 95%CI [0.405-0.875], P = 0.008) and PFS (HR: 0.707, 95%CI [0.538-0.930], P = 0.013). OS and PFS nomograms showed excellent predictive performance with the C-indexes of 0.783 and 0.720, respectively. The calibration plots and DCA also indicated the good predictability of the nomograms. Finally, subgroup analysis further demonstrated a favorable impact of HALP on both OS and PFS.

Conclusion: Preoperative HALP score can be used as a reliable independent predictor of OS and PFS in BC patients, and the nomograms may provide a personalized treatment strategy.

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乳腺癌患者血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分的预后意义：倾向评分匹配研究。

背景：血红蛋白-白蛋白-淋巴细胞-血小板（HALP）评分是评估全身炎症反应、营养和免疫状态的综合指标。本研究旨在探讨 BC 患者术前 HALP 评分与预后之间的关系，并制定预测性提名图：方法：收集中山大学肿瘤防治中心2010年12月至2014年4月期间接受乳腺切除术的BC患者的临床病理资料。通过对总生存率数据进行最大选择秩统计，确定HALP的最佳临界值。应用倾向评分匹配（PSM）建立了高HALP组和低HALP组的可比队列。通过 Kaplan-Meier 曲线和 Cox 回归分析来确定 HALP 对 BC 患者的影响。根据多变量 Cox 回归方法，绘制了预后提名图。然后，应用一致性指数（C-index）、校准图和决策曲线分析（DCA）来评估提名图的预后效果：共有1856名患者被纳入原发队列，1470名患者被视为PSM队列。在主要队列中，高 HALP 组（≥ 47.89）和低 HALP 组（≥ 47.89）的 5 年总生存期（OS）和无进展生存期（PFS）率（结论：术前 HALP 评分可用于诊断癌症：术前 HALP 评分可作为 BC 患者 OS 和 PFS 的可靠独立预测指标，其提名图可提供个性化治疗策略。

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来源期刊

Cancer Cell International ONCOLOGY-

CiteScore

10.90

自引率

1.70%

发文量

360

审稿时长

1 months

期刊介绍： Cancer Cell International publishes articles on all aspects of cancer cell biology, originating largely from, but not limited to, work using cell culture techniques. The journal focuses on novel cancer studies reporting data from biological experiments performed on cells grown in vitro, in two- or three-dimensional systems, and/or in vivo (animal experiments). These types of experiments have provided crucial data in many fields, from cell proliferation and transformation, to epithelial-mesenchymal interaction, to apoptosis, and host immune response to tumors. Cancer Cell International also considers articles that focus on novel technologies or novel pathways in molecular analysis and on epidemiological studies that may affect patient care, as well as articles reporting translational cancer research studies where in vitro discoveries are bridged to the clinic. As such, the journal is interested in laboratory and animal studies reporting on novel biomarkers of tumor progression and response to therapy and on their applicability to human cancers.