Buz Mesut, Sesigüzel Mehmet İlhan, Özsaray Yunus Emre, Özdemir Attila, Doğruyol Mahmut Talha, Çimenoğlu Riza Berk, Demirhan Recep
Department of Thoracic Surgery, Kartal Dr. Lütfi Kirdar City Hospital, Istanbul, Turkey.
Medicine (Baltimore). 2025 Aug 22;104(34):e43985. doi: 10.1097/MD.0000000000043985.
Non-small cell lung cancer (NSCLC) has a high mortality rate, emphasizing the need for reliable preoperative prognostic tools. Recent studies have focused on markers that reflect both inflammatory and nutritional status. This study aimed to evaluate the prognostic value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in predicting postoperative outcomes in NSCLC patients. This retrospective observational study included patients diagnosed with NSCLC who underwent curative surgery between January 1, 2019, and January 1, 2024. Preoperative HALP scores were calculated from routine blood tests to assess their potential as independent predictors of survival and long-term outcomes. The study cohort comprised 238 patients, divided into 2 groups: survivors (n = 153, 64.3%) and deceased patients (n = 85, 35.7%). The median HALP score was significantly lower in the deceased group (31.2) compared to survivors (52.3; P < .001). Follow-up duration was also significantly shorter in the deceased group (median 22 months) compared to survivors (median 34 months; P < .001). In the Cox univariate analysis, age ≥ 65 years (hazard ratio [HR] 2.02, 95% confidence intervals [CI] 1.32-3.1, P = .002), positive surgical margins (HR 3.04, 95% CI 1.61-5.76, P = .003), and low HALP scores (HR 5.17, 95% CI 3.33-8.03, P < .001) were significantly associated with decreased survival. However, in the multivariate analysis, positive surgical margins (HR 2.74, 95% CI 1.35-5.56, P = .005) and low HALP scores (HR 5.80, 95% CI 3.6-9.3, P < .001) remained independent predictors of decreased survival, while age ≥ 65 years did not retain significance. These findings suggest that positive surgical margins and low HALP scores are key prognostic factors for survival in NSCLC patients. The HALP score was identified as an independent predictor of postoperative mortality in NSCLC patients. Lower scores were significantly associated with higher mortality, indicating its potential use in both risk assessment and guiding postoperative management.
非小细胞肺癌（NSCLC）死亡率高，这凸显了对可靠术前预后工具的需求。最近的研究集中在反映炎症和营养状况的标志物上。本研究旨在评估血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分在预测NSCLC患者术后结局方面的预后价值。这项回顾性观察性研究纳入了2019年1月1日至2024年1月1日期间接受根治性手术的NSCLC患者。通过常规血液检查计算术前HALP评分，以评估其作为生存和长期结局独立预测指标的潜力。研究队列包括238例患者，分为两组：幸存者（n = 153，64.3%）和死亡患者（n = 85，35.7%）。死亡组的HALP评分中位数（31.2）显著低于幸存者（52.3；P <.001）。死亡组的随访时间中位数（22个月）也显著短于幸存者（34个月；P <.001）。在Cox单因素分析中，年龄≥65岁（风险比[HR] 2.02，95%置信区间[CI] 1.32 - 3.1，P =.002）、手术切缘阳性（HR 3.04，95% CI 1.61 - 5.76，P =.003）和低HALP评分（HR 5.17，95% CI 3.33 - 8.03，P <.001）与生存率降低显著相关。然而，在多因素分析中，手术切缘阳性（HR 2.74，95% CI 1.35 - 5.56，P =.005）和低HALP评分（HR 5.80，95% CI 3.6 - 9.3，P <.001）仍然是生存率降低的独立预测指标，而年龄≥65岁不再具有统计学意义。这些发现表明，手术切缘阳性和低HALP评分是NSCLC患者生存的关键预后因素。HALP评分被确定为NSCLC患者术后死亡率的独立预测指标。较低的评分与较高的死亡率显著相关，表明其在风险评估和指导术后管理方面的潜在用途。
