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Keywords = HALP score

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14 pages, 760 KiB  
Article
HALP-H Index as a Prognostic Biomarker for Predicting Pathological Complete Response in Early-Stage HER2-Positive Breast Cancer—A Multicenter Retrospective Cohort Study
by Mustafa Seyyar, Pervin Can Şancı, Tolga Köşeci, Anıl Karakayalı, Mutianur Özkorkmaz Akdağ, Yasemin Bakkal Temi, Kazım Uygun, Umut Kefeli, Burak Mete and Devrim Çabuk
J. Clin. Med. 2025, 14(13), 4431; https://doi.org/10.3390/jcm14134431 - 22 Jun 2025
Viewed by 361
Abstract
Objectives: Inflammation plays an important role in cancer development, and various inflammation parameters are used as potential prognostic markers. This study aimed to evaluate the effectiveness of the combined use of HALP and H index in predicting pathological response to neoadjuvant therapy in [...] Read more.
Objectives: Inflammation plays an important role in cancer development, and various inflammation parameters are used as potential prognostic markers. This study aimed to evaluate the effectiveness of the combined use of HALP and H index in predicting pathological response to neoadjuvant therapy in patients with HER2-positive early-stage breast cancer. Method: This retrospective cohort study was conducted on 146 HER2-positive breast cancer patients treated in two centers. To stratify patients by their predicted probability of pathological response, HALP and H index values were combined into a composite biomarker score called the combined response score (CRS). Patients were classified into three groups based on biomarker levels: 0 = low CRS (low predictive score), 1 = intermediate CRS, and 2 = high CRS (high predictive score). These groups reflect predicted response likelihood and do not represent actual pathological outcomes. Pathological response results were evaluated according to the combined response score. Pathological complete response (pCR) was defined as residual cancer burden (RCB) 0, indicating no residual invasive tumor in breast or lymph nodes. Results: The mean age of 146 early-stage breast cancer patients included in our study was 52.3 ± 11.3 (min: 29-max: 83). In the ROC analysis, the optimum cut-off value for the HALP score in pathological response classification was found to be 36 (AUC = 0.608, sensitivity = 76.29%, specificity = 44.9%, PPV = 73%, NPV = 47.89%) and 2.3 for the H index (AUC = 0.641, sensitivity = 65.98%, specificity = 51.02%, PPV = 72.73%, NPV = 43.1%). While the pathological complete response rate was 66.4% in all patients, it was 81.8% in those with a combined score of 2, 51% in those with a score of 1, and 58.6% in those with a score of 0 (p < 0.001). In the logistic regression analysis, the probability of pathological response in patients in the combined score = 2 group is 3.77 times higher than in group 0. In the Fagan nomogram, the pretest probability of pathological response is 66%, while the post-test probability for combined response score group 2 is 81.5%, and for the low-H index < 2.3 and the high-HALP ≥ 36 patient group, our estimate for pathological complete response increases to 82%. Conclusions: The HALP-H index combined score is an important predictor of pathological response in early-stage HER2-positive breast cancer patients, independent of histological type and stage. This new score may enable personalized approaches in treatment planning. Full article
(This article belongs to the Section Oncology)
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12 pages, 979 KiB  
Article
Evolution and Optimization of the HALP Formula for Predicting Free Flap Failure: A Progressive Analysis of Predictive Accuracy
by Gabriele Monarchi, Umberto Committeri, Massimiliano Gilli, Giovanni Salzano, Stefania Troise, Giuseppe Consorti, Roberto Benedetti, Paolo Balercia and Antonio Tullio
Surgeries 2025, 6(2), 44; https://doi.org/10.3390/surgeries6020044 - 30 May 2025
Viewed by 461
Abstract
Background: Reconstructive surgery with free flaps is a fundamental component in head and neck surgery, but flap failure remains a significant concern. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a prognostic factor commonly applied in the evaluation of patients suffering from [...] Read more.
Background: Reconstructive surgery with free flaps is a fundamental component in head and neck surgery, but flap failure remains a significant concern. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a prognostic factor commonly applied in the evaluation of patients suffering from malignant tumours. This score has emerged as a potential preoperative risk assessment tool; however, its predictive accuracy for free flap failure has not been fully evaluated. The potential of this formula, in the cervical–facial reconstructive area, has not yet been well studied in the international literature. Methods: This retrospective study included patients who had undergone free flap reconstruction in the maxillofacial surgery departments of Perugia and Ancona over the past ten years. To optimize the HALP formula, advanced machine learning technologies, mainly the Julius AI platform, were applied. The HALP formula was refined through three phases: the original formula, a weighted version, and the final “Modified HALP.” Predictive performance was assessed using ROC curve analysis, multivariate logistic regression, and internal validation. Results: The final version of the HALP score, created in the present study, achieved an AUC-ROC of 0.95 (95% CI: 0.91–0.99), outperforming the original and weighted versions. At the optimal cut-off, the final “Modified” HALP score demonstrated 90.91% sensitivity and 92.36% specificity, remaining an independent predictor of flap failure after adjusting for confounders. Conclusions: The aim of the study was to optimize the HALP score by integrating clinical information with the aim of making significant progress in the prediction of failure in reconstructive flaps. The Modified HALP score emerges as a powerful tool for preoperative risk stratification in free flap surgery, potentially improving patient outcomes through targeted interventions. Future research should focus on external validation and exploring the underlying biological mechanisms. Full article
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12 pages, 1038 KiB  
Article
The Role of Preoperative Immunonutritional Scores in Predicting Complications After Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease
by Marina Raguž, Marko Tarle, Petar Marčinković, Hana Chudy, Darko Orešković, Vladimira Vuletić, Tonko Marinović and Darko Chudy
J. Clin. Med. 2025, 14(11), 3811; https://doi.org/10.3390/jcm14113811 - 29 May 2025
Viewed by 535
Abstract
Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder associated with systemic inflammation, immune dysregulation, and malnutrition, all of which may influence surgical outcomes. Subthalamic nucleus deep brain stimulation (STN DBS) is a widely used treatment for advanced PD, yet postoperative complications [...] Read more.
Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder associated with systemic inflammation, immune dysregulation, and malnutrition, all of which may influence surgical outcomes. Subthalamic nucleus deep brain stimulation (STN DBS) is a widely used treatment for advanced PD, yet postoperative complications remain a concern. This study evaluates the predictive value of preoperative immunonutritional markers—including the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, Aggregate Index of Systemic Inflammation (AISI), Lymphocyte-to-Monocyte Ratio (LMR), and systemic inflammatory response syndrome (SIRS)—for the risk of extracranial complications following STN DBS. Methods: A retrospective cohort study was conducted on 138 PD patients who underwent STN DBS. Clinical and laboratory data were analyzed to assess the association between preoperative immunonutritional markers and postoperative complications, including infections, wound healing disturbances, and surgical revisions. Logistic regression and receiver operating characteristic (ROC) analysis were performed to evaluate the predictive power of these markers. Results: SIRS emerged as the strongest predictor of complications (aOR = 6.99, 95% CI = 1.844–26.509), emphasizing the critical role of systemic inflammation in surgical outcomes. HALP, AISI, and LMR also demonstrated significant predictive potential, with HALP (AUC = 0.69) and LMR (AUC = 0.73) being the most robust predictors of complications. While albumin alone was not a significant predictor, it correlated with inflammatory markers and comorbidities, underscoring its role in broader risk assessments. Conclusions: This study underscores the value of preoperative immunonutritional markers in predicting complications following STN DBS in PD patients. Incorporating these markers into clinical risk stratification may enhance preoperative planning and personalized postoperative care, ultimately improving surgical outcomes. These findings, while promising, warrant validation through prospective, multicenter studies to refine predictive models and enhance patient outcomes. Full article
(This article belongs to the Section Clinical Neurology)
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12 pages, 1349 KiB  
Article
Dynamic Alteration of HALP Score as a Predictor in Patients with Receiving Immunotherapy for Advanced Non-Small Cell Lung Cancer
by Abdülkadir Koçanoğlu, Serdar Karakaya, Esra Zeynelgil, Yakup Düzköprü and Özlem Doğan
Medicina 2025, 61(6), 989; https://doi.org/10.3390/medicina61060989 - 27 May 2025
Viewed by 482
Abstract
Background and Objectives: This study aimed to investigate the prognostic value of the hemoglobin–albumin–lymphocyte–platelet (HALP) score—a marker reflecting both inflammatory and nutritional status—in patients with metastatic non-small cell lung cancer (NSCLC) undergoing immunotherapy. We also sought to determine whether dynamic changes in [...] Read more.
Background and Objectives: This study aimed to investigate the prognostic value of the hemoglobin–albumin–lymphocyte–platelet (HALP) score—a marker reflecting both inflammatory and nutritional status—in patients with metastatic non-small cell lung cancer (NSCLC) undergoing immunotherapy. We also sought to determine whether dynamic changes in the HALP score during treatment could predict therapeutic success and help distinguish between pseudoprogression and hyperprogression. Materials and Methods: A retrospective analysis was conducted on 160 patients diagnosed with metastatic NSCLC and treated with immunotherapy at the Ankara Atatürk Sanatorium Training and Research Hospital. Chemotherapy regimens, metastatic sites, baseline and third-month hemograms and biochemistry parameters, and survival data were recorded. Survival outcomes were analyzed using the Kaplan–Meier method with the log-rank test and the Cox proportional hazards regression model using IBM SPSS Statistics. Results: The median overall survival (OS) for the entire cohort was 15 months (95% CI: 11.88–18.12). HALP1 score (p = 0.048), HALP2 score (p = 0.026), and hyperprogression (p < 0.001) were statistically significant predictors of OS. Regarding progression-free survival (PFS), the HALP2 score (p = 0.031), line of immunotherapy (p = 0.046), and hyperprogression (p < 0.001) were found to be significant. When comparing patients with increasing versus decreasing HALP scores, those with increasing HALP scores demonstrated significantly better outcomes for both OS (p = 0.034) and PFS (p = 0.007). Conclusions: In patients with metastatic NSCLC undergoing immunotherapy, the HALP score and its dynamic alterations during treatment appear to be non-invasive, easily calculable biomarkers that may predict both OS and PFS. Full article
(This article belongs to the Section Oncology)
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12 pages, 535 KiB  
Article
Utilizing Albumin Value, HALP Score and LCR Value for Predicting Survival in Patients with Pancreatic Adenocarcinoma
by Tufan Gumus, Veysel Umman, Bekir Cetin and Alper Uguz
Medicina 2025, 61(4), 639; https://doi.org/10.3390/medicina61040639 - 1 Apr 2025
Viewed by 548
Abstract
Background and Objectives: This study aimed to determine whether albumin levels and the ratios of key biochemical markers, including the hemoglobin, albumin, lymphocyte, and platelet (HALP score) and lymphocyte/C-reactive protein ratio (LCR), can predict survival and recurrence in patients with pancreatic adenocarcinoma. [...] Read more.
Background and Objectives: This study aimed to determine whether albumin levels and the ratios of key biochemical markers, including the hemoglobin, albumin, lymphocyte, and platelet (HALP score) and lymphocyte/C-reactive protein ratio (LCR), can predict survival and recurrence in patients with pancreatic adenocarcinoma. Materials and Methods: A total of 87 patients who underwent surgery for pancreatic adenocarcinoma in our clinic between January 2017 and December 2021 were included. Preoperative albumin levels, HALP scores, and LCR values were calculated and analyzed to evaluate their predictive value for pathological findings in the early postoperative period. Results: The mean age of the study population was 64.8 ± 9.6 years; 59 patients (67.8%) were male, and 28 (32.2%) were female. The cut-off values for HALP, LCR, and albumin were 34.4, 0.61, and 38.55, respectively. Patients with low HALP scores had significantly shorter overall survival than those with high scores (15.8 vs. 19.3 months; p < 0.01). Similarly, patients with low LCR scores showed shorter survival than those with high scores (17.8 vs. 18.5 months; p < 0.01). High albumin levels were associated with significantly longer survival compared to low albumin levels (16.3 vs. 14.6 months; p < 0.01). Conclusions: Low HALP scores and low albumin levels were identified as significant independent prognostic factors for both disease-free and overall survival in patients with pancreatic adenocarcinoma. Full article
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12 pages, 991 KiB  
Article
Prognostic Significance of the Combined Albumin-To-Alkaline Phosphatase Ratio (AAPR) and Haemoglobin–Albumin–Lymphocyte–Platelet (HALP) Score in Patients with Metastatic Renal Cell Carcinoma Treated by Targeted Therapy: A New Prognostic Combined Risk Scoring
by Tolga Köşeci, Mustafa Seyyar, Mehmet Mutlu Kıdı, Sedat Biter, Kadir Eser, Umut Kefeli, Erdinç Nayır, Berna Bozkurt Duman, Burak Mete, Hakan Demirhindi and Timuçin Çil
J. Clin. Med. 2025, 14(5), 1742; https://doi.org/10.3390/jcm14051742 - 5 Mar 2025
Cited by 1 | Viewed by 718
Abstract
Background/Objectives: Renal cell carcinoma (RCC) accounts for 2–3% of all cancers, with approximately 25% of patients being detected at the metastatic stage. This study aimed to determine the prognostic significance of co-evaluating two risk parameters: one, the HALP score based on haemoglobin, albumin, [...] Read more.
Background/Objectives: Renal cell carcinoma (RCC) accounts for 2–3% of all cancers, with approximately 25% of patients being detected at the metastatic stage. This study aimed to determine the prognostic significance of co-evaluating two risk parameters: one, the HALP score based on haemoglobin, albumin, lymphocyte, and platelet counts, and the other, albumin-to-alkaline phosphatase ratio (AAPR) in patients with metastatic RCC treated with targeted therapy. Methods: This retrospective cohort study included 147 patients with metastatic RCC. The HALP score and AAPR values were calculated from pre-treatment blood test results, and followingly, the cut-off value was determined by using ROC analysis. Patients were categorised into three groups with a low, moderate or high combined risk score based on this cut-off value. The effect of these risk groups on survival was evaluated. Results: The mean age of patients was 64.1 ± 11.9. The median follow-up time was 38.3 months, and the mortality rate was 53.7% in all groups. Kaplan–Meier survival analysis showed a statistically significant difference between the combined scores of the risk groups: the median survival time was 51.6 months in the low-risk group, 20.7 months in the medium-risk group, and 10.4 months in the high-risk group (p < 0.001), with 5-year survival rates being 38.8% in the low-risk group, 30% in the intermediate-risk group, and 19% in the high-risk group. When compared to the low-risk group, Cox regression analysis revealed that the mortality risk, i.e., HR (hazard ratio), was 2.42 times higher in the intermediate-risk group and 3.76 times higher in the high-risk group. A nephrectomy operation decreased the mortality risk (HR = 0.24) by 4.16 times. Conclusions: This new combined risk scoring, obtained from co-evaluating the HALP score and AAPR, was found to be an independent prognostic factor in metastatic RCC patients. This combined risk scoring is expected to help clinicians in treatment decisions. Full article
(This article belongs to the Section Oncology)
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16 pages, 1254 KiB  
Article
Prognostic Value of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) Score in Patients with Metastatic Renal Cell Carcinoma Treated with Nivolumab
by Zuzana Tomčová, Jana Obertová, Michal Chovanec, Zuzana Syčová-Milá, Katarína Štefániková, Eva Šlachtová, Monika Žák, Alexander Savka, Matej Hrnčár, Katarína Rejleková and Patrik Palacka
Biomedicines 2025, 13(2), 484; https://doi.org/10.3390/biomedicines13020484 - 16 Feb 2025
Viewed by 980
Abstract
Background: Immunotherapy based on checkpoint inhibition is widely used in the treatment of metastatic renal cell carcinoma (RCC); however, predictive and prognostic biomarkers are yet to be explored. The objective of this study was to evaluate the prognostic value of the hemoglobin, albumin, [...] Read more.
Background: Immunotherapy based on checkpoint inhibition is widely used in the treatment of metastatic renal cell carcinoma (RCC); however, predictive and prognostic biomarkers are yet to be explored. The objective of this study was to evaluate the prognostic value of the hemoglobin, albumin, lymphocyte, platelet (HALP) score in metastatic RCC patients receiving nivolumab. Methods: We enrolled 149 individuals (including 38 females) with a median age of 62 years, who were treated with nivolumab (at a dosage of 240 mg biweekly or 480 mg every 28 days) following progression on at least one tyrosine kinase inhibitor (TKI) between 2016 and 2024. The study population was dichotomized by the median HALP score (27.53), which was calculated as hemoglobin (g/L) × albumin (g/L) × absolute lymphocyte count/platelets (g/L) at immunotherapy initiation. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method, with differences analyzed via a log-rank test. A multivariate Cox proportional hazards model was utilized for evaluation of the prognostic value of performance status, lactate dehydrogenase (LDH) levels, and HALP score. Results: At a median follow-up of 31.1 months, 122 patients had progressed on nivolumab and 87 had died. Poor performance status was associated with significantly worse PFS and OS (HR 0.20 and 0.14, respectively). Survival was worse in individuals with an LDH level higher than 1.5 times the normal range compared to those with lower LDH values (HR 0.45 for PFS and HR 0.41 for OS). Patients with low HALP scores had shorter PFS (HR 0.69) and OS (HR 0.58) versus patients with high HALP scores. In the multivariate analysis, the independent prognostic value of the HALP index for OS was revealed in a metastatic clear-cell RCC (ccRCC) population. Conclusions: The HALP score determined before nivolumab initiation as the second or third line of treatment is an independent prognostic factor of OS in metastatic ccRCC patients. Prospective validation could lead to the incorporation of this index into prognostic models for patients with RCC. Full article
(This article belongs to the Special Issue Advances in Immunotherapy and Radiation Therapy for Cancer)
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18 pages, 1894 KiB  
Article
Effect of Hemoglobin, Albumin, Lymphocyte Count, and Platelet (HALP) Score on Survival of Patients with Metastatic Thyroid Cancer Treated with Tyrosine Kinase Inhibitors
by Hikmet Öztop, Fazıl Çağrı Hunutlu, Selin İldemir Ekizoğlu, Özen Öz Gül, Soner Cander and Ahmet Bilgehan Şahin
J. Clin. Med. 2025, 14(4), 1306; https://doi.org/10.3390/jcm14041306 - 16 Feb 2025
Cited by 1 | Viewed by 849
Abstract
Tyrosine kinase inhibitors (TKIs) are crucial for improving the survival rates of individuals with metastatic thyroid cancer. Moreover, systemic inflammation and malnutrition are known to negatively affect metastatic thyroid cancer prognosis. Evaluating nutritional status at the start of treatment can improve survival rates. [...] Read more.
Tyrosine kinase inhibitors (TKIs) are crucial for improving the survival rates of individuals with metastatic thyroid cancer. Moreover, systemic inflammation and malnutrition are known to negatively affect metastatic thyroid cancer prognosis. Evaluating nutritional status at the start of treatment can improve survival rates. Purpose: This study investigated the correlation between the hemoglobin, albumin, lymphocyte count, and platelet (HALP) score and prognosis of patients with metastatic thyroid cancer undergoing first-line TKI therapy. Methods: We retrospectively analyzed data from 44 patients between January 2010 and June 2024. The primary outcomes evaluated in the study were time to treatment failure (TTF) and overall survival (OS); HALP scores were categorized as low (≤29.21) and high (>29.21) based on receiver operating characteristic analysis. Results: The 1-year survival rate was significantly lower in the low HALP score group compared to the high HALP score group (50% vs. 96.3%). Multivariate Cox regression analysis revealed that low HALP scores, elevated leukocyte counts, and lymphopenia were independent predictors of shorter TTF (HR = 0.272, p = 0.011) and OS (HR = 0.208, p = 0.028). Conclusions: The results obtained in the present study demonstrate that the HALP score has prognostic significance for patients with metastatic thyroid cancer who are undergoing first-line TKI treatment. In metastatic thyroid cancer patients, interventions focused on improving nutritional status at the start, during initiation, and throughout the TKI treatment may enhance treatment effectiveness. However, further prospective studies involving larger patient cohorts are necessary to validate our results. Full article
(This article belongs to the Section Oncology)
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12 pages, 554 KiB  
Article
Predictive Utility of the HALP and Modified HALP Score for the Assessment of Operative Complications in Patients Undergoing Laparoscopic Cholecystectomy for Acute Cholecystitis
by Yasemin Keskin, Hakan Sevinç, Selçuk Mevlüt Hazinedaroğlu, Şevket Barış Morkavuk and Şiyar Ersöz
Diagnostics 2025, 15(2), 152; https://doi.org/10.3390/diagnostics15020152 - 10 Jan 2025
Cited by 1 | Viewed by 887
Abstract
Background and Objectives: The aim of the present study was to calculate HALP and modified HALP scores for patients diagnosed with acute cholecystitis (AC) and to determine the predictive utility of these scores for surgical timing and morbidity in patients who underwent [...] Read more.
Background and Objectives: The aim of the present study was to calculate HALP and modified HALP scores for patients diagnosed with acute cholecystitis (AC) and to determine the predictive utility of these scores for surgical timing and morbidity in patients who underwent surgery for AC. Materials and Methods: This study included data from 641 patients who underwent surgery for AC between January 2010 and May 2023. The HALP score was calculated using the formula hemoglobin (g/L) × albumin (g/L) × lymphocyte (109/L)/platelets (109/L). The modified HALP score was calculated using the formula hemoglobin (g/L) × albumin (g/L) × lymphocyte (109/L) × platelets (109/L). Results: The mean HALP score was 46.81, and the mean modified HALP score was 2,758,401.21. Laparoscopic cholecystectomy (LC) was successfully completed in 582 (90.8%) patients. When examining the relationship between HALP and modified HALP scores and the procedure type, a statistically significant difference was found in the distribution of median HALP and modified HALP scores between the LC and laparoscopic and open cholecystectomy (LTOC) groups. For patients with a HALP score < 34.43 and modified HALP score < 2,077,019, the likelihood of conversion to open surgery increased, with a sensitivity of 65.5% vs. 58.8% and a specificity of 66.1% vs. 59.3%. In patients who underwent surgery, there was a significant difference in the LTOC between the HALP score and modified HALP score cut-off groups (p < 0.001 and, p = 0.007). Conclusions: Evaluation of the HALP score is a promising and valuable assessment method for designing appropriate treatment and management strategies for patients with AC. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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11 pages, 1589 KiB  
Article
HALP Score in Predicting Response to Treatment in Patients with Early-Stage Gastric Cancer: A Multi-Centred Retrospective Cohort Study
by Tolga Köşeci, Mustafa Seyyar, Yasemin Aydınalp Camadan, Halil Çelik, Burak Mete, Hakan Demirhindi, Kadir Eser, Serdar Ata, Ali Alper Solmaz and Timuçin Çil
Medicina 2024, 60(12), 2087; https://doi.org/10.3390/medicina60122087 - 20 Dec 2024
Viewed by 1153
Abstract
Background and Objectives: The HALP (Haemoglobin, Albumin, Lymphocyte and Platelet) score is used to predict the prognosis of different types of cancer. This study aimed to investigate the role of the HALP score in predicting pathological response in early-stage gastric cancer patients. [...] Read more.
Background and Objectives: The HALP (Haemoglobin, Albumin, Lymphocyte and Platelet) score is used to predict the prognosis of different types of cancer. This study aimed to investigate the role of the HALP score in predicting pathological response in early-stage gastric cancer patients. Materials and Methods: This retrospective cohort study was conducted on 118 patients diagnosed with early-stage gastric cancer and subjected to perioperative (FLOT) treatment between 2018 and 2023. The role of the HALP score in predicting the pathological response to perioperative treatment in patients was investigated. Results: The mean age of the 118 patients included in the study was 61.3 ± 11.1 (min = 23; max = 86). In the ROC analysis, the optimum cut-off value for the HALP score in pathological response classification was found to be 28.9 (AUC = 0.710, sensitivity = 56.7%, specificity = 80%, PPV = 86.79%, NPV = 46.15%). The pathological response rate was 69% in all patients, 87% in patients with a HALP score ≥ 28.9, and 52% in patients with a HALP score < 28.9 (p < 0.001). The probability of pathological response is 6.5 times higher in patients with a HALP score ≥ 28.9. In the Fagan nomogram, when the HALP score was ≥28.9, our pathological response probability estimate (post-test response probability) was found to increase to 64.8% (Positive Likelihood Ratio = 3, Negative Likelihood Ratio = 0.53). In patients with HALP scores ≥ 28.9 and <28.9, progression rates were 16.7% and 47.8%, respectively (p < 0.001), and median survival times were 45.4 and 30.6 months (p < 0.001). Conclusions: The HALP score is a useful and easily accessible score for determining pathological responses in patients with locally advanced gastric cancer. Full article
(This article belongs to the Section Oncology)
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13 pages, 702 KiB  
Article
The Role of Inflammatory and Nutritional Indices in Postmenopausal Osteoporosis: A Retrospective Study
by Busra Demir Cendek, Burak Bayraktar, Mehmet Alican Sapmaz, Ayse Ecenaz Yıldırım, Mujde Can Ibanoglu and Yaprak Engin Ustun
J. Clin. Med. 2024, 13(24), 7741; https://doi.org/10.3390/jcm13247741 - 18 Dec 2024
Cited by 3 | Viewed by 1289
Abstract
Background: Postmenopausal osteoporosis is characterized by impaired bone metabolism, inflammation, and nutritional deficiencies. This study aimed to evaluate the potential of inflammatory and nutritional markers in identifying decreased bone mineral density (BMD) in postmenopausal women. Methods: This cross-sectional study retrospectively analyzed [...] Read more.
Background: Postmenopausal osteoporosis is characterized by impaired bone metabolism, inflammation, and nutritional deficiencies. This study aimed to evaluate the potential of inflammatory and nutritional markers in identifying decreased bone mineral density (BMD) in postmenopausal women. Methods: This cross-sectional study retrospectively analyzed postmenopausal women from January 2018 and December 2023. A total of 368 women were divided into three groups based on T-scores: 61 women with osteoporosis (T-score ≤ −2.5), 153 women with osteopenia (−1 > T-score > −2.5), and 154 women with normal BMD (T-score > −1). Inflammatory and nutritional biomarkers included the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune inflammation value (PIV), geriatric nutritional risk index (GNRI), triglycerides, total cholesterol, and body weight index (TCBI), prognosis nutritional index (PNI), hemoglobin, albumin, lymphocyte, and platelet (HALP) score, 25-OH Vitamin D level, Na, K, Ca, Mg, and their ratios. Results: The GNRI was significantly lower in the osteoporosis group compared to the control group. The NLR, PLR, SII, SIRI, PIV, TCBI, PNI, and HALP were similar between the groups. The GNRI and TCBI showed a positive correlation with T-scores. The Mg level was lower in the osteoporosis group than in the control group and osteopenia group, and the Na/Mg ratio was higher. Additionally, the Ca/Mg ratio was lower in the osteoporosis group than in the control group. The T-score was positively correlated with Mg and Ca/Mg, while the Na/Mg ratio showed a significant negative correlation. Vitamin D, other minerals, and their ratios did not show significant differences between the groups. Conclusions: Our findings suggest that the GNRI could serve as a useful indicator for assessing bone health and the risk of osteoporosis. Furthermore, maintaining appropriate levels of Mg and balanced Na/Mg and Ca/Mg ratios appears crucial for BMD. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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11 pages, 542 KiB  
Article
Predictive Value of Inflammatory Scores for Left Atrium Thrombosis in Ischemic Stroke Without Atrial Fibrillation
by Vedat Cicek, Sahhan Kilic, Selami Dogan, Almina Erdem, Mert Babaoglu, Irem Yilmaz, Salih Karaismail, Murat Mert Atmaca, Mert Ilker Hayiroglu, Tufan Cinar and Ulas Bagci
Medicina 2024, 60(12), 2046; https://doi.org/10.3390/medicina60122046 - 12 Dec 2024
Cited by 3 | Viewed by 1278
Abstract
Background and Objectives: Studies have shown that inflammation markers can be used as prognostic tools in predicting acute ischemic stroke. In this study, we conducted a comparison of several inflammation scores in predicting left atrial thrombosis (LAT) in patients with ischemic stroke [...] Read more.
Background and Objectives: Studies have shown that inflammation markers can be used as prognostic tools in predicting acute ischemic stroke. In this study, we conducted a comparison of several inflammation scores in predicting left atrial thrombosis (LAT) in patients with ischemic stroke without AF. Materials and Methods: In this single-center, retrospective study, we included 303 consecutive patients with ischemic stroke. Each patient underwent a transesophageal echocardiography (TEE) examination within 10 days of admission to detect the presence of LAT. To identify independent predictors of LAT, we conducted a multivariate logistic regression analysis. Results: In total, 303 patients who had ischemic stroke were included in the analysis. LAT was detached in 34 patients at the time of the TEE examination. The patients were categorized into two groups based on their LAT status. The Prognostic Nutritional Index (PNI), HALP score, and C-reactive Protein–Albumin Ratio (CAR) were identified as statistically significant predictors of LAT. Based on the results of the multivariate regression analysis, the CAR emerged as the only independent predictor of LAT. Conclusions: Among several inflammation scores, the PNI, HALP, and CAR were statistically significant predictors of LAT in ischemic stroke patients without AF. CAR was identified as the optimal score for the prediction of LAT in patients with stroke and without AF. Full article
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13 pages, 995 KiB  
Article
Blood-Based Clinical Biomarkers of Inflammation and Nutrition in Hyperemesis Gravidarum
by Busra Demir Cendek, Burak Bayraktar, Zeynep Seyhanli, Ezgi Kocyildiz, Hakan Golbasi, Mujde Can Ibanoglu and Yaprak Engin Ustun
J. Clin. Med. 2024, 13(23), 7289; https://doi.org/10.3390/jcm13237289 - 30 Nov 2024
Cited by 1 | Viewed by 1179
Abstract
Background: In this study, the aim was to investigate blood-based clinical biomarkers of inflammation and nutrition indices in hyperemesis gravidarum (HG). Methods: This retrospective case–control study was conducted at a tertiary hospital between 2018 and 2022. A total of 820 pregnant [...] Read more.
Background: In this study, the aim was to investigate blood-based clinical biomarkers of inflammation and nutrition indices in hyperemesis gravidarum (HG). Methods: This retrospective case–control study was conducted at a tertiary hospital between 2018 and 2022. A total of 820 pregnant women were enrolled in this study; 410 pregnant women were diagnosed with HG (HG group) at 6–14 weeks of gestation, and 410 pregnant women were healthy controls (control group) in the same gestational weeks. Patients’ demographic and clinical characteristics and laboratory parameters were recorded. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, the modified-HALP (m-HALP) score, and the prognostic nutritional index (PNI) were calculated. Results: The HALP score (32.6 (IQR: 24.9–41.5) vs. 39.2 (IQR: 30.8–49.2), p < 0.001) and the PNI score (50 (IQR: 46.3–53.6) vs. 51.3 (IQR: 48.6–53.8), p < 0.001) were significantly lower in the HG group, whereas the m-HALP score was similar between the groups. The HALP score had an AUC of 0.625 (95% CI: 0.586–0.664), with the optimal cut-off value set at 35.8, resulting in a sensitivity of 59.7% and a specificity of 59.5% (p < 0.001). Similarly, the PNI score showed an AUC of 0.580 (95% CI: 0.541–0.619), and the optimal cut-off value was set at 50.6, resulting in a sensitivity of 54.9% and a specificity of 54.9% (p < 0.001). In regression analysis, lower HALP scores (OR: 0.906, 95% CI: 0.833–0.984, p = 0.019) and lower PNI scores (OR: 0.941, 95% CI: 0.891–0.995, p = 0.033) were significantly associated with HG, highlighting their potential as diagnostic markers. Additionally, a negative statistically significant correlation was observed between PNI scores and ketonuria (r = −0.073, p = 0.036). Conclusions: This study demonstrated a decrease in the HALP score and PNI score in cases of HG. However, the m-HALP score was similar in the HG and control groups. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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15 pages, 1533 KiB  
Article
The Importance of Biochemical Parameters, Immunonutritional Status, and Social Support for Quality of Life in Chronic Hemodialysis Patients
by Batric Babovic, Natasa Belada Babovic, Filip Tomovic, Snezana Radovanovic, Mladen Debeljevic, Dusan Mustur and Olgica Mihaljevic
Medicina 2024, 60(11), 1751; https://doi.org/10.3390/medicina60111751 - 24 Oct 2024
Cited by 1 | Viewed by 1930
Abstract
Background and Objectives: Chronic kidney disease (CKD) is a growing public health problem and one of the leading causes of premature death worldwide. The progressive nature of CKD is associated with serious complications that can reduce the quality of life in CKD [...] Read more.
Background and Objectives: Chronic kidney disease (CKD) is a growing public health problem and one of the leading causes of premature death worldwide. The progressive nature of CKD is associated with serious complications that can reduce the quality of life in CKD patients. Additional factors that can worsen well-being include dialysis treatment, malnutrition, inflammation, and lack of social support. The aim of our study was to analyze the quality of life of CKD patients undergoing hemodialysis and its association with certain biochemical and immunonutritional parameters, as well as with social support. Materials and Methods: This research was conducted as a cross-sectional study that included 170 patients, divided into two groups: a group of patients undergoing hemodialysis (HD group) (n = 85), and a control group of non-hemodialysis patients (group with CKD stage 3–4) (n = 85). The Health-Related Quality of Life (HRQoL) score was used to assess the quality of life of the study population. Measurement of biochemical and immunonutritional parameters was also performed in all patients. The Oslo-3 Social Support Scale (OSSS-3) was used to analyze social support. Results: The HRQoL score was significantly lower in HD patients compared to patients with CKD stage 3–4 (0.701 ± 0.137 vs. 0.832 ± 0.122, p < 0.001). It declined significantly as the concentrations of urea (β = −0.347, p < 0.001), creatinine (β = −0.699, p = 0.005), uric acid (β = −0.184, p = 0.016), β2-microglobulin (β = −0.432, p < 0.001), and parathormone (β = −0.209, p = 0.006) increased in HD patients. In addition to uremic toxins, an increase in glucose (β = −0.278, p = 0.010) and triglyceride (β = −0.354, p = 0.001) concentrations was associated with poor HRQoL in patients with CKD stage 3–4. There was a significant connection between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score and HRQoL in HD patients (β = 0.229, p = 0.035). Additionally, C-reactive protein (β = −0.361, p < 0.001) and neutrophil-to-lymphocyte ratio (β = −0.288, p < 0.001), as markers of systemic inflammation, directly affected HRQoL in HD patients. In both study groups, perceived social support positively influenced the HRQoL scores (β = 0.192, p = 0.012 for hemodialysis; β = 0.225, p = 0.038 for non-hemodialysis). Conclusions: There is a decline in HRQoL in chronic hemodialysis patients, significantly affected by certain biochemical and immunonutritional parameters, along with perceived social support. Full article
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15 pages, 267 KiB  
Article
New Approaches Based on Inflammatory Indexes in the Evaluation of the Neoplastic Potential of Colon Polyps
by Sedat Ciftel, Serpil Ciftel, Aleksandra Klisic and Filiz Mercantepe
Life 2024, 14(10), 1259; https://doi.org/10.3390/life14101259 - 2 Oct 2024
Cited by 1 | Viewed by 1587
Abstract
Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective [...] Read more.
Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective cross-sectional study was conducted on 758 patients aged 61.0 ± 11.8 who underwent polypectomy between June 2021 and May 2024. Patients with colorectal adenocarcinoma (n = 22) were excluded. The polyps were classified into neoplastic and nonneoplastic categories based on histopathological evaluation. The study compared the CALLY index, HALP score, and various inflammatory indexes between neoplastic and nonneoplastic polyps. Out of 758 polyps analyzed, 514 were neoplastic, and 244 were nonneoplastic. Neoplastic polyps exhibited significantly lower CALLY and HALP scores (p < 0.05) and higher immuno-inflammatory indexes (p < 0.05) compared to nonneoplastic polyps. Dysplasia status, polyp diameter, and sigmoid colon localization were significant factors in determining neoplastic growth potential. No significant differences were observed in polyp localization in the proximal and distal colon segments or in solitary versus multiple polyps. The CALLY and HALP scores and immuno-inflammatory indexes can serve as valuable markers for distinguishing neoplastic from nonneoplastic polyps. These indexes reflect underlying inflammatory and immune responses, highlighting their potential utility in the early detection and risk stratification of colorectal polyps. Integrating these markers into clinical practice may enhance diagnostic accuracy and improve patient management, leading to timely interventions and better outcomes for individuals at risk of CRC. Full article
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