Predictive Role of Halp Score, LCR Value and CRP-Albumin Ratio for Survival and Recurrence in Gastric Cancer
Öz
Objective: To investigate whether the ratios of biochemical markers such as hemoglobin, albumin, lymphocyte and platelet (HALP) score, lymphocyte-C-reactive protein ratio (LCR) and CRP/Albumin ratio can predict the survival and recurrence of the disease in gastric cancer patients.
Materials and Methods: Adult patients who were operated for gastric cancer in our clinic between January 2014 and December 2023 (n: 85) were included in this retrospective study. HALP and CRP/Albumin scores and LCR ratios were calculated from the preoperative biochemical data of the patients.
Results: Overall survival of patients with a low HALP score was significantly shorter than that of patients with a high HALP score (30.6 vs 35.5 months) (p<0.05). In addition, overall survival of patients with low LCR rate was significantly shorter than that of patients with high LCR score (27.9 vs 35.6 months, p<0.05), and similarly, the overall survival of patients with low CRP/Albumin value was significantly shorter than that of patients with high CRP/Albumin value (29.9 months vs 32.4 months) (p<0.05). There was a strong correlation between HALP, LCR, and CRP/Albumin scores and recurrence (for each p<0.05). According to the results of multivariate Cox regression analysis, HALP score, LCR score and CRP/albumin ratio were found to be independent and positive factors for overall survival (p<0.05).
Conclusions: Low scores in any of the HALP, LCR, and CRP/Albumin scores were associated with poor postoperative overall survival and recurrence in patients with gastric cancer.
Anahtar Kelimeler
Etik Beyan
Ethics committee approval was obtained from the the Sakarya University Ethics Committee (Date 28.12.2023, Decision No: E. 318701). The study was carried out following the Helsinki Declaration, international guidelines. This study was conducted in accordance with the principles of the Declaration of Helsinki. Since it was a retrospective study, informed consent/consent form was not obtained from the patient/relatives.
Kaynakça
- Yang WJ, Zhao HP, Yu Y, et al. Updates on global epidemiology, risk and prognostic factors of gastric cancer. World J Gastroenterol. 2023;29(16):2452-2468. doi:10.3748/wjg.v29.i16.2452
- Ilic M, Ilic I. Epidemiology of stomach cancer. World J Gastroenterol. 2022;28(12):1187-1203. doi:10.3748/wjg.v28.i12.1187
- Zhang X, Zhao W, Yu Y, et al. Clinicopathological and prognostic significance of platelet-lymphocyte ratio (PLR) in gastric cancer: an updated meta-analysis. World J Surg Oncol. 2020;18(1):191. doi:10.1186/s12957-020-01952-2
- Harmantepe AT, Ozdemir K, Bayhan Z, Kocer B. The underestimated impact of Hashimoto thyroiditis on thyroid papillary carcinoma. Updates Surg. 2024;76(3):1085-1089. doi:10.1007/s13304-024-01854-y
- Harmantepe AT, Dikicier E, Gönüllü E, Ozdemir K, Kamburoğlu MB, Yigit M. A different way to diagnosis acute appendicitis: machine learning. Pol Przegl Chir. 2023;96(2):38-43. doi:10.5604/01.3001.0053.5994
- Harmantepe AT, Bas E, Akdeniz Y, Kucuk A, Bayhan Z, Kocer HB. A novel index to predict postoperative hypocalcemia in primary hyperparathyroidism. Ir J Med Sci. 2024;193(3):1261-1266. doi:10.1007/s11845-024-03613-9
- Harmantepe AT, Kocer B, Bayhan Z, Gonullu E, Dulger UC. The unexpected effect of parathyroid adenoma on inflammation. Updates Surg. 2024;76(2):589-593. doi:10.1007/s13304-023-01734-x
- Çekmen B, Kolcu G. C-Reaktif Protein/Albumin Oranının İleus Tipini ve Prognozu Belirlemedeki Yeri. Med J SDU. 2022;29(1):121-126.
- Harmantepe AT, Dulger UC, Gonullu E, Dikicier E, Şentürk A, Eröz E. A method for predicting mortality in acute mesenteric ischemia: Machine learning. Ulus Travma Acil Cerrahi Derg. 2024;30(7):487-492. doi:10.14744/tjtes.2024.48074
- Guo Y, Shi D, Zhang J, et al. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel significant prognostic factor for patients with metastatic prostate cancer undergoing cytoreductive radical prostatectomy. J Cancer. 2019;10(1):81-91. doi:10.7150/jca.27210
- Lu LH, Zhong C, Wei W, et al. Lymphocyte-C-reactive protein ratio as a novel prognostic index in intrahepatic cholangiocarcinoma: A multicentre cohort study. Liver Int. 2021;41(2):378-387. doi:10.1111/liv.14567
- Kim MH, Ahn JY, Song JE, et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS One. 2015;10(7):e0132109. doi:10.1371/journal.pone.0132109
- Akgül GG. The Relationship Between the HALP score and gastric cancer prognosis. J Eur Int Med Prof. 2023;1(4):156-161.
- Ettrich TJ, Seufferlein T. Systemic therapy for metastatic pancreatic cancer. Curr Treat Options Oncol. 2021;22(11):106. doi:10.1007/s11864-021-00895-4
- Yalav O, Department of General Surgery, Cukurova University School of Medicine, Adana, Turkey, Topal U, et al. Clinical value of hemoglobin and albumin levels and lymphocyte and platelet count (HALP) combination in predicting postoperative complications, lymph node positivity and prognosis in gastric cancer patients who underwent curative surgical resection. Cyprus J Med Sci. 2020;5(2):145-152. doi:10.5152/cjms.2020.1747
- Chen XL, Xue L, Wang W, et al. Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget. 2015;6(38):41370-41382. doi:10.18632/oncotarget.5629
- Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost. 2015;114(3):449-458. doi:10.1160/TH14-12-1067
- Peng D, Zhang CJ, Gong YQ, et al. Prognostic significance of HALP (hemoglobin, albumin, lymphocyte and platelet) in patients with bladder cancer after radical cystectomy. Sci Rep. 2018;8(1):794. doi:10.1038/s41598-018-19146-y
- Sargin ZG, Dusunceli I. The effect of HALP score on the prognosis of gastric adenocarcinoma. J Coll Physicians Surg Pak. 2022;32(9):1154-1159. doi:10.29271/jcpsp.2022.09.1154
- Fan Z, Luo G, Gong Y, et al. Prognostic value of the C-reactive protein/lymphocyte ratio in pancreatic cancer. Ann Surg Oncol. 2020;27(10):4017-4025. doi:10.1245/s10434-020-08301-3
- Okugawa Y, Toiyama Y, Yamamoto A, et al. Lymphocyte-to-C-reactive protein ratio and score are clinically feasible nutrition-inflammation markers of outcome in patients with gastric cancer. Clin Nutr. 2020;39(4):1209-1217. doi:10.1016/j.clnu.2019.05.009
- Mei D, Zhao B, Zhang J. Effect of lymphovascular invasion on survival outcomes in patients with gastric cancer. Am J Clin Pathol. 2020;153(6):833-841.
- Eckart A, Struja T, Kutz A, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: A prospective study. Am J Med. 2020;133(6):713-722.e7. doi:10.1016/j.amjmed.2019.10.031
- Toyokawa T, Muguruma K, Yoshii M, et al. Clinical significance of prognostic inflammation-based and/or nutritional markers in patients with stage III gastric cancer. BMC Cancer. 2020;20(1):517. doi:10.1186/s12885-020-07010-0
- Liu XY, Zhang X, Ruan GT, et al. One-year mortality in patients with cancer cachexia: Association with albumin and total protein. Cancer Manag Res. 2021;13:6775-6783. doi:10.2147/cmar.s318728
- Nico R, Veziant J, Chau A, Eveno C, Piessen G. Optimal lymph node dissection for gastric cancer: a narrative review. World J Surg Oncol. 2024;22(1):108. doi:10.1186/s12957-024-03388-4
- Maruyama K, Katai H, -. Surgical treatment of gastric cancer in Japan, trend from standardization to individualization. Chirurgia (Bucur). 2014;109(6):722-730. https://pubmed.ncbi.nlm.nih.gov/25560493/
- Marques P, Barry S, Carlsen E, et al. Chemokines modulate the tumour microenvironment in pituitary neuroendocrine tumours. Acta Neuropathol Commun. 2019;7(1):172. doi:10.1186/s40478-019-0830-3
- Chen M, Zheng SH, Yang M, Chen ZH, Li ST. The diagnostic value of preoperative inflammatory markers in craniopharyngioma: a multicenter cohort study. J Neurooncol. 2018;138(1):113-122. doi:10.1007/s11060-018-2776-x
Öz
Amaç: Hemoglobin, albumin, lenfosit ve trombosit (HALP) skoru, lenfosit-C-reaktif protein oranı (LCR) ve CRP/Albumin oranı gibi biyokimyasal belirteçlerin oranlarının mide kanseri hastalarında hastalığın sağ kalımını ve tekrarını tahmin edip edemeyeceğini araştırmak.
Materyal ve Metot: Ocak 2014 ile Aralık 2023 tarihleri arasında kliniğimizde mide kanseri nedeniyle opere edilen yetişkin hastalar (n: 85) bu retrospektif çalışmaya dahil edildi. Hastaların preoperatif biyokimyasal verilerinden HALP ve CRP/Albumin skorları ve LCR oranları hesaplandı.
Bulgular: Düşük HALP skorlu hastaların genel sağ kalım süresi, yüksek HALP skorlu hastalara göre anlamlı derecede daha kısaydı (30.6'ya karşı 35.5 ay) (p<0,05). Ayrıca, düşük LCR oranına sahip hastaların genel sağ kalım süresi, yüksek LCR skorlu hastalara göre anlamlı derecede daha kısaydı (27.9'a karşı 35.6 ay, p<0,05) ve benzer şekilde, düşük CRP/Albumin değerine sahip hastaların genel sağ kalımı, yüksek CRP/Albumin değerine sahip hastalara göre anlamlı derecede daha kısaydı (29.9'a karşı 32.4 ay) (p<0,05). HALP, LCR ve CRP/Albumin skorları ile tekrarlama arasında güçlü bir korelasyon vardı (her biri için p<0,05). Çok değişkenli Cox regresyon analizinin sonuçlarına göre, HALP skoru, LCR skoru ve CRP/albumin oranının genel sağ kalım için bağımsız ve pozitif faktörler olduğu bulundu (p<0,05).
Sonuç: HALP, LCR ve CRP/Albumin skorlarından herhangi birinde düşük skorlar, mide kanseri olan hastalarda düşük postoperatif genel sağ kalım ve nüks ile ilişkiliydi.
Anahtar Kelimeler
Etik Beyan
Etik kurul onayı Sakarya Üniversitesi Etik Kurulu'ndan alındı (Tarih 28.12.2023, Karar No: E. 318701). Çalışma Helsinki Deklarasyonu, uluslararası kılavuzlar izlenerek gerçekleştirildi. Bu çalışma Helsinki Deklarasyonu ilkelerine uygun olarak yürütüldü. Retrospektif bir çalışma olduğundan hasta/yakınlarından bilgilendirilmiş onam/onam formu alınmadı.
Kaynakça
- Yang WJ, Zhao HP, Yu Y, et al. Updates on global epidemiology, risk and prognostic factors of gastric cancer. World J Gastroenterol. 2023;29(16):2452-2468. doi:10.3748/wjg.v29.i16.2452
- Ilic M, Ilic I. Epidemiology of stomach cancer. World J Gastroenterol. 2022;28(12):1187-1203. doi:10.3748/wjg.v28.i12.1187
- Zhang X, Zhao W, Yu Y, et al. Clinicopathological and prognostic significance of platelet-lymphocyte ratio (PLR) in gastric cancer: an updated meta-analysis. World J Surg Oncol. 2020;18(1):191. doi:10.1186/s12957-020-01952-2
- Harmantepe AT, Ozdemir K, Bayhan Z, Kocer B. The underestimated impact of Hashimoto thyroiditis on thyroid papillary carcinoma. Updates Surg. 2024;76(3):1085-1089. doi:10.1007/s13304-024-01854-y
- Harmantepe AT, Dikicier E, Gönüllü E, Ozdemir K, Kamburoğlu MB, Yigit M. A different way to diagnosis acute appendicitis: machine learning. Pol Przegl Chir. 2023;96(2):38-43. doi:10.5604/01.3001.0053.5994
- Harmantepe AT, Bas E, Akdeniz Y, Kucuk A, Bayhan Z, Kocer HB. A novel index to predict postoperative hypocalcemia in primary hyperparathyroidism. Ir J Med Sci. 2024;193(3):1261-1266. doi:10.1007/s11845-024-03613-9
- Harmantepe AT, Kocer B, Bayhan Z, Gonullu E, Dulger UC. The unexpected effect of parathyroid adenoma on inflammation. Updates Surg. 2024;76(2):589-593. doi:10.1007/s13304-023-01734-x
- Çekmen B, Kolcu G. C-Reaktif Protein/Albumin Oranının İleus Tipini ve Prognozu Belirlemedeki Yeri. Med J SDU. 2022;29(1):121-126.
- Harmantepe AT, Dulger UC, Gonullu E, Dikicier E, Şentürk A, Eröz E. A method for predicting mortality in acute mesenteric ischemia: Machine learning. Ulus Travma Acil Cerrahi Derg. 2024;30(7):487-492. doi:10.14744/tjtes.2024.48074
- Guo Y, Shi D, Zhang J, et al. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel significant prognostic factor for patients with metastatic prostate cancer undergoing cytoreductive radical prostatectomy. J Cancer. 2019;10(1):81-91. doi:10.7150/jca.27210
- Lu LH, Zhong C, Wei W, et al. Lymphocyte-C-reactive protein ratio as a novel prognostic index in intrahepatic cholangiocarcinoma: A multicentre cohort study. Liver Int. 2021;41(2):378-387. doi:10.1111/liv.14567
- Kim MH, Ahn JY, Song JE, et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS One. 2015;10(7):e0132109. doi:10.1371/journal.pone.0132109
- Akgül GG. The Relationship Between the HALP score and gastric cancer prognosis. J Eur Int Med Prof. 2023;1(4):156-161.
- Ettrich TJ, Seufferlein T. Systemic therapy for metastatic pancreatic cancer. Curr Treat Options Oncol. 2021;22(11):106. doi:10.1007/s11864-021-00895-4
- Yalav O, Department of General Surgery, Cukurova University School of Medicine, Adana, Turkey, Topal U, et al. Clinical value of hemoglobin and albumin levels and lymphocyte and platelet count (HALP) combination in predicting postoperative complications, lymph node positivity and prognosis in gastric cancer patients who underwent curative surgical resection. Cyprus J Med Sci. 2020;5(2):145-152. doi:10.5152/cjms.2020.1747
- Chen XL, Xue L, Wang W, et al. Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget. 2015;6(38):41370-41382. doi:10.18632/oncotarget.5629
- Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost. 2015;114(3):449-458. doi:10.1160/TH14-12-1067
- Peng D, Zhang CJ, Gong YQ, et al. Prognostic significance of HALP (hemoglobin, albumin, lymphocyte and platelet) in patients with bladder cancer after radical cystectomy. Sci Rep. 2018;8(1):794. doi:10.1038/s41598-018-19146-y
- Sargin ZG, Dusunceli I. The effect of HALP score on the prognosis of gastric adenocarcinoma. J Coll Physicians Surg Pak. 2022;32(9):1154-1159. doi:10.29271/jcpsp.2022.09.1154
- Fan Z, Luo G, Gong Y, et al. Prognostic value of the C-reactive protein/lymphocyte ratio in pancreatic cancer. Ann Surg Oncol. 2020;27(10):4017-4025. doi:10.1245/s10434-020-08301-3
- Okugawa Y, Toiyama Y, Yamamoto A, et al. Lymphocyte-to-C-reactive protein ratio and score are clinically feasible nutrition-inflammation markers of outcome in patients with gastric cancer. Clin Nutr. 2020;39(4):1209-1217. doi:10.1016/j.clnu.2019.05.009
- Mei D, Zhao B, Zhang J. Effect of lymphovascular invasion on survival outcomes in patients with gastric cancer. Am J Clin Pathol. 2020;153(6):833-841.
- Eckart A, Struja T, Kutz A, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: A prospective study. Am J Med. 2020;133(6):713-722.e7. doi:10.1016/j.amjmed.2019.10.031
- Toyokawa T, Muguruma K, Yoshii M, et al. Clinical significance of prognostic inflammation-based and/or nutritional markers in patients with stage III gastric cancer. BMC Cancer. 2020;20(1):517. doi:10.1186/s12885-020-07010-0
- Liu XY, Zhang X, Ruan GT, et al. One-year mortality in patients with cancer cachexia: Association with albumin and total protein. Cancer Manag Res. 2021;13:6775-6783. doi:10.2147/cmar.s318728
- Nico R, Veziant J, Chau A, Eveno C, Piessen G. Optimal lymph node dissection for gastric cancer: a narrative review. World J Surg Oncol. 2024;22(1):108. doi:10.1186/s12957-024-03388-4
- Maruyama K, Katai H, -. Surgical treatment of gastric cancer in Japan, trend from standardization to individualization. Chirurgia (Bucur). 2014;109(6):722-730. https://pubmed.ncbi.nlm.nih.gov/25560493/
- Marques P, Barry S, Carlsen E, et al. Chemokines modulate the tumour microenvironment in pituitary neuroendocrine tumours. Acta Neuropathol Commun. 2019;7(1):172. doi:10.1186/s40478-019-0830-3
- Chen M, Zheng SH, Yang M, Chen ZH, Li ST. The diagnostic value of preoperative inflammatory markers in craniopharyngioma: a multicenter cohort study. J Neurooncol. 2018;138(1):113-122. doi:10.1007/s11060-018-2776-x
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Cerrahi (Diğer) |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 24 Haziran 2025 |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 25 Mart 2025 |
| Kabul Tarihi | 16 Haziran 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 10 Sayı: 2 |
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