结直肠癌肝转移灶切除术后血红蛋白、白蛋白、淋巴细胞、血小板（HALP）评分的预后意义

Prognostic significance of the hemoglobin, albumin, lymphocyte, platelet (HALP) score after hepatectomy for colorectal liver metastases.

作者信息

Okazaki Kohei, Furukawa Kenei, Haruki Koichiro, Onda Shinji, Shirai Yoshihiro, Tsunematsu Masashi, Taniai Tomohiko, Matsumoto Michinori, Hamura Ryoga, Akaoka Munetoshi, Uwagawa Tadashi, Ikegami Toru

机构信息

Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

出版信息

Surg Today. 2025 Jan 20. doi: 10.1007/s00595-025-02993-4.

DOI:10.1007/s00595-025-02993-4

PMID:39828751

Abstract

PURPOSE

Inflammatory, nutritional, and immune biomarkers are associated with the prognosis of patients with various tumors. Recently, a comprehensive predictive biomarker, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, was introduced to predict clinical outcomes. We investigated the prognostic impact of preoperative HALP scores in patients who underwent hepatectomy for colorectal liver metastasis (CRLM).

METHOD

The subjects of this study were 209 patients who underwent hepatectomy for CRLM between February, 2005 and September, 2023. The HALP score was defined as (albumin [mg/dL] × hemoglobin [g/L] × lymphocyte [count/L]) / platelet [count/L]. The cutoff value was calculated according to the receiver operating characteristic curve based on 3-year survival.

RESULTS

The cutoff value of the HALP score was 35, and a low HALP score was confirmed in 107 patients (51%). Multivariate analysis of disease-free survival identified lymph node metastasis (HR 1.53, p = 0.03), extrahepatic lesions (HR 2.48, p < 0.01), and a low HALP score (HR 2.0, p < 0.01) as independently poor prognostic factors. Multivariate analysis of overall survival identified extrahepatic lesions (HR 2.98, p < 0.01), a high CEA (HR 1.78, p = 0.02), and a low HALP score (HR 1.92, p = 0.02) as independently poor prognostic factors.

CONCLUSIONS

The HALP score is a useful prognostic factor for patients undergoing hepatectomy for CRLM.

摘要

目的

炎症、营养和免疫生物标志物与各种肿瘤患者的预后相关。最近，一种综合预测生物标志物——血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分被引入以预测临床结果。我们研究了术前HALP评分对接受结直肠癌肝转移（CRLM）肝切除术患者预后的影响。

方法

本研究的对象是2005年2月至2023年9月期间接受CRLM肝切除术的209例患者。HALP评分定义为（白蛋白[mg/dL]×血红蛋白[g/L]×淋巴细胞[计数/L]）/血小板[计数/L]。根据基于3年生存率的受试者工作特征曲线计算临界值。

结果

HALP评分的临界值为35，107例患者（51%）被证实HALP评分较低。无病生存的多因素分析确定淋巴结转移（HR 1.53，p = 0.03）、肝外病变（HR 2.48，p < 0.01）和低HALP评分（HR 2.0，p < 0.01）为独立的不良预后因素。总生存的多因素分析确定肝外病变（HR 2.98，p < 0.01）、高癌胚抗原（HR 1.78，p = 0.02）和低HALP评分（HR 1.92，p = 0.02）为独立的不良预后因素。