HALP评分和GNRI：预测晚期非小细胞肺癌患者预后的简单且易于获取的指标。伊兹密尔肿瘤学组（IZOG）研究。
HALP score and GNRI: Simple and easily accessible indexes for predicting prognosis in advanced stage NSCLC patients. The İzmir oncology group (IZOG) study.
作者信息
Güç Zeynep Gülsüm, Alacacıoğlu Ahmet, Kalender Mehmet Eren, Oflazoğlu Utku, Ünal Sinan, Yıldız Yaşar, Salman Tarık, Küçükzeybek Yüksel, Tarhan Mustafa Oktay
机构信息
Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey.
Department of Medical Oncology, Institute of Oncology, Dokuz Eylül University, İzmir, Turkey.
出版信息
Front Nutr. 2022 Aug 18;9:905292. doi: 10.3389/fnut.2022.905292. eCollection 2022.
OBJECTIVE
The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and the Geriatric Nutrition Risk Index (GNRI) are used as prognostic factors in different types of cancers. In this study we analyzed the prognostic value of the HALP Score and the GNRI calculated prior to first-line treatment in patients diagnosed with metastatic non-small cell lung cancer (mNSCLC).
MATERIALS AND METHODS
mNSCLC patients were retrospectively evaluated from January 2016 to December 2019. Patients with Driver's mutation, severe comorbidities, active infection, or insufficient organ function, and those receiving anti-inflammatory treatment were excluded from the study. Optimal cut-off points for the HALP score and the GNRI were calculated with the receiver operating characteristic (ROC) curve analysis. Predictive factors for overall survival (OS) were assessed with univariate and multivariate Cox proportional hazard analyses, and OS was studied with the Kaplan-Meier analysis.
RESULTS
The study included 401 patients in total. In the ROC curve analysis, the cut-off points were found 23.24 (AUC = 0.928; 95% CI: 0.901-0.955, < 0.001) for HALP, and 53.60 (AUC = 0.932; 95% CI: 0.908-0.955, < 0.001) for GNRI. Groups with lower HALP scores and lower GNRI had significantly shorter OS compared to those with higher HALP scores and GNRIs. Univariate analysis showed that male gender, smoking, high ECOG score, low HALP score and low GNRI were associated with worse survival rates. Multivariate analysis showed that low HALP score (HR = 2.988, 95% CI: 2.065-4.324, < 0.001); low GNRI score (HR = 2.901, 95% CI: 2.045-4.114, < 0.001) and smoking history (HR = 1.447, 95% CI: 1.046-2.001, = 0.025) were independent factors associated with worse OS rates.
CONCLUSION
Our study showed the HALP score and the GNRI to be of prognostic value as simple, cost-effective, and useful markers that predict OS in mNSCLC patients.
目的
血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分以及老年营养风险指数（GNRI）被用作不同类型癌症的预后因素。在本研究中，我们分析了一线治疗前计算的HALP评分和GNRI对转移性非小细胞肺癌（mNSCLC）患者的预后价值。
材料与方法
对2016年1月至2019年12月的mNSCLC患者进行回顾性评估。排除有驱动基因突变、严重合并症、活动性感染或器官功能不全的患者，以及接受抗炎治疗的患者。通过受试者工作特征（ROC）曲线分析计算HALP评分和GNRI的最佳截断点。采用单因素和多因素Cox比例风险分析评估总生存期（OS）的预测因素，并通过Kaplan-Meier分析研究OS。
结果
本研究共纳入401例患者。在ROC曲线分析中，HALP的截断点为23.24（AUC = 0.928；95%CI：0.901 - 0.955，P < 0.001），GNRI的截断点为53.60（AUC = 0.932；95%CI：0.908 - 0.955，P < 0.001）。与HALP评分和GNRI较高的组相比，HALP评分和GNRI较低的组OS明显较短。单因素分析显示，男性、吸烟、高ECOG评分、低HALP评分和低GNRI与较差的生存率相关。多因素分析显示，低HALP评分（HR = 2.988，95%CI：2.065 - 4.324，P < 0.001）；低GNRI评分（HR = 2.901，95%CI：2.045 - 4.114，P < 0.001）和吸烟史（HR = 1.447，95%CI：[1.046 - 2.001，P = 0.025]）是与较差OS率相关的独立因素。
结论
我们的研究表明，HALP评分和GNRI作为简单、经济有效且有用的标志物，对预测mNSCLC患者的OS具有预后价值。
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