Dusunceli Ibrahimhalil, Sargin Zeynep Gok, Celik Umut, Sargin Fatih
Department of Gastroenterology and Hepatology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkiye.
Department of Gastroenterology and Hepatology, Kirikkale University Faculty of Medicine, Kirikkale, Turkiye.
North Clin Istanb. 2024 Nov 22;11(6):555-559. doi: 10.14744/nci.2024.23169. eCollection 2024.
Cholestatic diseases are common and classified as benign or malignant based on their etiology. HALP is a unique nutritional immune marker that combines indicators of nutritional status, including hemoglobin and albumin, with immune function markers like lymphocyte and platelet counts. We investigated the HALP score's ability to differentiate between benign and malignant causes in extrahepatic cholestasis patients.
This research was designed as cross-sectional and retrospective. Between 1 January 2020-1 January 2022, patients diagnosed with extrahepatic cholestasis were included. The diagnoses were confirmed using non-invasive imaging methods, ERCP (endoscopic retrograde cholangiopancreatography), and tissue biopsy results. Based on the type of extrahepatic biliary obstruction, either benign or malignant, the patients were divided into two groups. The HALP score was calculated by multiplying the patient's albumin (g/L), hemoglobin (g/L), and lymphocyte count (/L) and dividing by the platelet count (/L).
In 121 of 216 patients, extrahepatic cholestasis was caused by benign factors, mostly choledocholithiasis, while malignant causes, predominantly pancreatic head cancer, were responsible for extrahepatic cholestasis in 95 patients. The malignant cholestasis group had significantly higher bilirubin levels (p<0.001), lower hemoglobin levels (p=0.005), lower albumin levels (p<0.001), higher lymphocyte counts (p<0.001), and higher platelet levels (p=0.001) compared to the benign cholestasis group. There was no considerable difference in the HALP score between the two groups, as indicated by a p-value of 0.741.
The HALP score could not distinguish between benign and malignant causes of extrahepatic cholestasis.
胆汁淤积性疾病很常见，根据病因可分为良性或恶性。HALP是一种独特的营养免疫标志物，它将包括血红蛋白和白蛋白在内的营养状况指标与淋巴细胞和血小板计数等免疫功能指标结合起来。我们研究了HALP评分在肝外胆汁淤积患者中区分良性和恶性病因的能力。
本研究设计为横断面回顾性研究。纳入2020年1月1日至2022年1月1日期间诊断为肝外胆汁淤积的患者。诊断通过非侵入性成像方法、内镜逆行胰胆管造影（ERCP）和组织活检结果得以证实。根据肝外胆管梗阻的类型是良性还是恶性，将患者分为两组。HALP评分通过将患者的白蛋白（g/L）、血红蛋白（g/L）和淋巴细胞计数（/L）相乘，再除以血小板计数（/L）来计算。
216例患者中，121例肝外胆汁淤积由良性因素引起，主要是胆总管结石，而95例患者的肝外胆汁淤积由恶性病因引起，主要是胰头癌。与良性胆汁淤积组相比，恶性胆汁淤积组的胆红素水平显著更高（p<0.001），血红蛋白水平更低（p=0.005），白蛋白水平更低（p<0.001），淋巴细胞计数更高（p<0.001），血小板水平更高（p=0.001）。两组之间的HALP评分没有显著差异，p值为0.741表明了这一点。
HALP评分无法区分肝外胆汁淤积的良性和恶性病因。
