Li Qin, Chen Mengqi, Zhao Huaqin, Zeng Jiawei
Department of Clinical Laboratory, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Department of Respiratory and Critical Care Medicine, the Second People's Hospital of Deyang City, Deyang, Sichuan, China.
Front Immunol. 2025 Jun 26;16:1576326. doi: 10.3389/fimmu.2025.1576326. eCollection 2025.
The prognostic role of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in non-small cell lung cancer (NSCLC) has been widely reported, but the results remain controversial. Therefore, we aim to evaluate the prognostic and clinicopathological value of the HALP score in NSCLC through a pooled analysis.
We conducted a comprehensive literature search of PubMed, Embase, Web of Science, Cochrane Library, and the ClinicalTrials.gov databases in December 2024 to identify studies evaluating the relationship between the pretreatment HALP score and outcomes in NSCLC patients. Eligible studies included patients treated with surgical resection, chemotherapy, or immunotherapy. The HALP score was calculated using peripheral blood levels of hemoglobin, albumin, lymphocytes, and platelets measured before treatment. Data were extracted and analyzed to determine the association of the HALP score with overall survival (OS), disease/progression/recurrence-free survival (DFS/PFS/RFS), and clinicopathological characteristics. Subgroup and sensitivity analyses were performed to ensure the robustness and reliability of the results.
A total of 10 studies involving 7024 patients were included. The results demonstrated that patients with lower pretreatment HALP score had worse OS (hazard ratio [HR] = 1.73, 95% confidence interval [95% CI]: 1.27-2.34, p < 0.001) and DFS/PFS/RFS (HR = 1.86, 95% CI: 1.30-2.64, p < 0.001). The results remained consistent across subgroup analyses based on study characteristics and sensitivity analyses. Additionally, a lower HALP score was significantly associated with age (odds ratio [OR] = 1.43, 95% CI: 1.15-1.78, p = 0.001) and tumor size (OR = 0.54, 95% CI: 0.38-0.76, p < 0.001).
The HALP score is a valuable prognostic biomarker for predicting survival outcomes in NSCLC patients. Its ability to integrate multiple aspects of systemic inflammation and nutritional status makes it a promising tool for improving risk stratification and guiding treatment decisions. Future studies should continue to validate this finding in prospective, multicentre trials.
血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分在非小细胞肺癌（NSCLC）中的预后作用已有广泛报道，但结果仍存在争议。因此，我们旨在通过汇总分析评估HALP评分在NSCLC中的预后及临床病理价值。
2024年12月，我们对PubMed、Embase、Web of Science、Cochrane图书馆和ClinicalTrials.gov数据库进行了全面的文献检索，以确定评估NSCLC患者治疗前HALP评分与预后关系的研究。符合条件的研究包括接受手术切除、化疗或免疫治疗的患者。HALP评分通过治疗前测量的外周血血红蛋白、白蛋白、淋巴细胞和血小板水平计算得出。提取并分析数据，以确定HALP评分与总生存期（OS）、疾病/进展/无复发生存期（DFS/PFS/RFS）及临床病理特征之间的关联。进行亚组分析和敏感性分析以确保结果的稳健性和可靠性。
共纳入10项研究，涉及7024例患者。结果表明，治疗前HALP评分较低的患者OS较差（风险比[HR]=1.73，95%置信区间[95%CI]：1.27 - 2.34，p<0.001），DFS/PFS/RFS也较差（HR = 1.86，95%CI：1.30 - 2.64，p<0.001）。基于研究特征的亚组分析和敏感性分析结果保持一致。此外，较低的HALP评分与年龄（优势比[OR]=1.43，95%CI：1.15 - 1.78，p = 0.001）和肿瘤大小（OR = 0.54，95%CI：0.38 - 0.76，p<0.001）显著相关。
HALP评分是预测NSCLC患者生存结局的有价值的预后生物标志物。其整合全身炎症和营养状况多个方面的能力使其成为改善风险分层和指导治疗决策的有前景的工具。未来的研究应在前瞻性多中心试验中继续验证这一发现。
