Search Results (118)

Objective: To investigate the safety and efficacy of Hassab’s surgery as a salvage treatment for patients with secondary prophylaxis failure for acute variceal bleeding (AVB), and to determine the role of Hassab’s surgery in the recompensation of cirrhosis and nutritional improvement. Methods: This study retrospectively analyzed data of 19 patients with AVB caused by cirrhosis and portal hypertension who underwent Hassab’s surgery as a salvage treatment after secondary prophylaxis failure in our center from March 2018 to June 2021. In addition, 47 patients with esophageal and gastric varices who underwent secondary prophylaxis during the same period were assigned to the control group to assess the safety and efficacy of the surgery. The objective laboratorial index and L3-SMA (the L3 skeletal muscle area, cm², a radiological index for assessing whole-body skeletal muscle mass via CT measurement at the third lumbar vertebra level) of patients in the experimental group before and after surgery were compared to evaluate re-compensation of cirrhosis and nutritional improvement. Results: There was no significant difference in the incidence of perioperative complications and severe complications (Clavien–Dindo grade ≥ IIIb) between the experimental group and the control group. The 5-year re-bleeding-free survival rate and the 5-year overall survival rate in the experimental group were 73.7% and 94.7%, respectively, which were not significantly different from those in the control group. In addition, compared with before surgery, the white blood cell count, platelet count, hemoglobin level, model for end-stage liver disease (MELD) score, Child–Pugh grades, prothrombin time (PT), international normalized ratio (INR), and L3-SMA significantly increased in the experimental group after surgery. Conclusions: Hassab’s surgery proves to be a safe and effective salvage treatment for patients with AVB caused by liver cirrhosis and portal hypertension who failed to undergo secondary prophylaxis. Meanwhile, it was found that after surgery, not only were hypersplenism and coagulation abnormalities relieved, but also cirrhosis was compensated and nutritional status was improved significantly. Thus, this study revealed that Hassab’s surgery with safety and long-term survival effects can be used for patients with secondary prophylaxis failure for AVB in eligible patients Full article

Background/Objectives: Breast cancer remains a major cause of cancer-related mortality among women worldwide, highlighting the need for new therapeutic strategies. Pyrimidine derivatives have shown promise in oncology due to their ability to modulate immune responses and influence tumor growth pathways. Methods: Cytotoxicity of Xymedon was evaluated using MTT and colony formation assays on cancer MCF-7, NCI-H322M, HCT-15 cells, and primary human foreskin fibroblasts. In vivo efficacy was assessed in an orthotopic MCF-7 xenograft model in female Balb/c nude mice. Xymedon was administered orally at 410 mg/kg daily alone or in combination with intraperitoneal doxorubicin (1 mg/kg weekly). Hematological, histological, and immunohistochemical analyses were performed. Results: In vitro, Xymedon (up to 3 mM) showed no cytotoxicity against cancer cell lines or human skin fibroblasts. In vivo, Xymedon significantly increased tumor necrosis (44.1% vs. 28.5%, p < 0.01) and enhanced intratumoral infiltration of CD3+, CD8+, and CD20+ lymphocytes, with peritumoral counts increasing 2.2–5.3-fold. It mitigated Doxorubicin-induced myelosuppression by improving red blood cell counts, hemoglobin, and hematocrit levels, while platelet recovery remained limited. Combination therapy with Xymedon did not affect tumor volume or weight, but resulted in a non-significant trend toward improved survival (80% vs. 30%, p ≈ 0.11; Hazard Ratio [HR] = 0.268, 95% CI: 0.07082 to 1.012) without affecting fibrous capsule formation. Conclusions: These results suggest that Xymedon is a non-cytotoxic immunomodulator with potential as an adjuvant to enhance antitumor immunity and reduce hematologic toxicity associated with chemotherapy. Further studies are needed to elucidate the molecular pathways and confirm clinical efficacy. Full article

Background: This study aimed to determine the relationship between nutritional status and systemic inflammation using four validated nutrition indices—Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score, and Nutritional Risk Index (NRI)—and three immune–inflammation biomarkers—Systemic Immune–Inflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)—in healthy adults with varying body mass index (BMI) levels. Methods: This retrospective study included 290 clinically healthy adults aged 18–60 years, categorized by BMI. Individuals with chronic diseases, medication use, or morbid obesity (BMI ≥ 40 kg/m²) were excluded. Nutrition scores (HALP, PNI, NRI, CONUT) and systemic immune–inflammation indices (SII, NLR, PLR) were calculated from laboratory data. For the comparisons of SII, PLR, NLR, PNI, HALP, NRI, and CONUT values between groups, age was adjusted for, and an ANCOVA test was performed. Results: Among the systemic immune–inflammation indices, SII and NLR were significantly higher in both the overweight and obesity groups. The CONUT score, a negative indicator of nutritional status, demonstrated positive correlations with SII, NLR, and PLR in the overweight group, and with PLR in the obesity group. Although PNI showed significant inverse correlations with SII, PLR, and NLR in both groups, the mean PNI values remained above 50, indicating overall normal nutritional status in the study population. HALP was inversely correlated with SII, PLR, and NLR in both groups. Conclusions: The HALP score appears to be the most reliable marker, as it reflects the inverse relationship between nutritional status and systemic immune–inflammation indices. Full article

Amanita exitialis is a lethal mushroom species found in southern China. Its amatoxins can cause acute liver injury with a high case-fatality rate. However, reports combining toxin detection in clinical specimens with autopsy pathology remain limited. We conducted a retrospective analysis of A. exitialis poisoning events treated at Chuxiong Yi Autonomous Prefecture People’s Hospital from 2019 to 2024. Toxins were measured in collected mushrooms, patient blood, and urine. Clinical data included demographics, complications, laboratory parameters, and autopsy findings. Associations between a time-weighted urinary amatoxin exposure metric and laboratory indices were assessed. Ten poisoning incidents involving 27 individuals were identified, including five deaths. We collected 10 mushroom samples, 120 urine samples, and 108 blood samples. α-amanitin, β-amanitin, phallacidin, and phallisacin were detected in mushrooms and urine. The detection rates of α-AMA, β-AMA, PCD, and PSC in urine samples were 31.67%, 5.00%, 38.33%, and 49.17%, respectively. Only three blood samples tested positive for α-AMA. The time-weighted urinary amatoxin exposure metric was positively correlated with total bilirubin (TBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), creatinine (Cr), creatine kinase (CK), creatine kinase isoenzymes (CK-MB), prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR). Early symptoms included nausea, vomiting, diarrhea, abdominal pain, and distention; later findings involved injury to the liver, kidneys, intestines, heart, and lungs. On the fourth day following ingestion, there was a marked increase in bilirubin levels and a concurrent decrease in liver enzymes, indicating severe damage to the hepatocytes. Platelet count, white blood cell count, hemoglobin, and red blood cell count decreased over time. Autopsies demonstrated hepatic, renal, and myocardial injury, gastrointestinal mucosal exfoliation, and multiorgan hemorrhage. In summary, A. exitialis poisoning is primarily characterized by liver damage, accompanied by injuries to the kidneys, myocardium, and intestines, as well as multiorgan hemorrhaging, which may lead to blood toxicity. The detection rate of toxins in urine samples is relatively high, and early urine toxin testing can help clarify the diagnosis and guide treatment. Full article

Background: Systemic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with severe COVID-19, but their role in mild disease among frail older adults remains unclear. Early Israeli admission policies enabled hematologic profiling of asymptomatic and mild cases. Methods: Retrospective cohort of adults ≥65 years admitted to a geriatric center (March 2020–March 2021). Patients with Mild/asymptomatic COVID-19 cases were compared with patients hospitalized for other infections (pneumonia, urinary tract infection, cellulitis). Admission indices such as NLR, derived neutrophil-to-lymphocyte ratio (dNLR), PLR, hemoglobin-to-lymphocyte ratio (HLR), red cell distribution width (RDW), and C-reactive protein (CRP) were analyzed using receiver operating characteristic (ROC) curves. Sensitivity analyses compared COVID-19 with bacterial pneumonia and assessed one-week changes. Results: Among 450 patients (177 COVID-19 and 273 non-COVID; median age 85–86), COVID-19 cases showed lower white blood cell counts (WBC), neutrophils, and CRP but more marked lymphopenia. The most discriminative indices were dNLR, PLR, HLR, and RDW, which differed most (all p < 0.001), while NLR and systemic immune-inflammation index (SII) showed limited discrimination. The best AUC was 0.69. dNLR, PLR, and HLR remained elevated after one week. Conclusions: In frail older adults with early or mild COVID-19, modest but consistent hematologic patterns, including lymphopenia with elevated dNLR, PLR, and HLR, and lower RDW, were distinguished COVID-19 from other infections, although single-marker accuracy was limited. These routine indices may assist early differentiation when virologic testing is delayed or unavailable. Full article

Background: Coronavirus disease (COVID-19), caused by SARS-CoV-2 infection, presents a broad spectrum of clinical manifestations, ranging from asymptomatic cases to severe and fatal outcomes. Studies have shown that laboratory parameters fluctuate in patients with COVID-19, and these parameters serve as valuable biomarkers for monitoring disease progression. This study examines the relationship between changes in biochemical and hematological markers and patient survival among early COVID-19 cases. Materials and methods: In this retrospective cohort study, data from adult (≥18 years) hospitalized COVID-19 patients with positive PCR results at HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakhon Nayok, Thailand, between March and December 2021, were analyzed. Univariate and multivariate logistic regression analyses were conducted on mortality-related laboratory parameters. All measures are reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: The cohort included 397 patients with pneumonia (median age: 52.2 years (IQR: 40.5–64.6); 61.96% female). Among them, 42 patients (10.58%) succumbed during hospitalization, with a median hospital stay of 12.92 days (IQR: 10.03–15.94). Independent mortality predictors were identified as follows: age (aOR = 1.11; 95% CI: 1.04–1.19; p = 0.002), potassium (aOR = 6.27; 95% CI: 1.31–29.93; p = 0.021), creatinine (aOR = 1.62; 95% CI: 1.05–2.50; p = 0.028), hemoglobin A1c (aOR = 1.96; 95% CI: 1.30–2.97; p = 0.001), and red cell distribution width (aOR = 1.45; 95% CI: 1.05–2.02; p = 0.026), respectively. Furthermore, patients with lower platelet counts had a notably higher risk of mortality (aOR = 0.98; 95% CI: 0.97–0.99; p = 0.001). Conclusions: Our findings suggest that age, potassium, creatinine, hemoglobin A1c, red cell distribution width, and platelet count are significant predictors of mortality risk in patients with COVID-19. Clinicians should consider these biochemical and hematological markers critically before initiating treatment for COVID-19 patients. Full article

Background/Objectives: There is a sudden and noticeably increasing focus on naturally found antiplatelet inhibitors that humans can use habitually. Given that athletes receive annual training with periods of recovery that are not always suitably adapted to the workload, this study aimed to explore the association between dietary fat intakes and the indices of blood profiles, concentrating on platelet variables in a sample of high-performance athletes. Methods: The sample encompassed 19.8 ± 2.2-year-old Lithuanian high-performance athletes (n = 82). The assessment of the nutritional profile of study participants was performed using a 3-day food record approach. In laboratory settings, the hematology profile of athletes was assessed via the Nihon Khoden automated hematology analyzer. Results: The recorded mean consumption of energy, carbohydrates, protein, and fat in elite athletes was 49 kcal/kg/day, 5.4 g/kg/day, 1.6 g/kg/day, and 40.3% of energy intake (EI), respectively. The study highlighted the excessive consumption of saturated fatty acids (FA) (13.4–14.3% of EI) and dietary cholesterol (698–982 mg/day). Also, considering that the ideal human omega-6 to omega-3 FA ratio is commonly deemed to be between 1:1 and 4:1, an athlete’s ‘Western diet’ was heavily skewed with a ratio fluctuating from 18.9:1 to 19:4 in favor of omega-6 FA. Furthermore, the study found that the outcomes related to slightly higher levels of blood platelet counts and plateletcrit, however, being within normal limits, were associated with a higher intake of omega-6 FA (adjusted odds ratio (AOR) 9.5, 95% confidence interval (CI) 1.2; 9.9, p = 0.029). A higher platelet-to-hemoglobin ratio as a novel indirect blood-based biomarker pronouncing the potential inflammatory processes in the body revealed the reverse relationship of higher intake levels of dietary omega-3 FA (AOR 6.7, 95% CI 1.3; 12.2, p = 0.029), omega-6 FA (AOR 6.2, 95% CI 2.7; 11.5, p = 0.009), and saturated FA (AOR 8.5, 95% CI 1.5; 9.1, p = 0.020) among elite athletes. Conclusions: The prospect of personalized nutrition targeted at the professional athletes’ segment may provide an innovative opportunity to increase athletes’ capacity to manage the platelet function via diet while stressing the importance of further empirical experimental research in this dynamic and vital biomedical field. Full article

Background: Pulmonary embolism (PE) represents a major complication in patients with hematologic malignancies, yet existing risk assessment models such as the Khorana and ThroLy scores show limited applicability in this population. Novel tools incorporating routinely available clinical and laboratory markers are needed for accurate risk stratification. Objectives: To investigate the incidence and predictors of PE in patients with hematologic malignancies and to develop a new risk stratification model, the Hema-PE Score. Methods: This retrospective study included a total of 177 patients with various hematologic malignancies who were evaluated for, of whom 63 had pulmonary embolism (PE) and 114 served as controls. Clinical variables (immobility, central venous catheter) and laboratory markers (D-dimer/albumin ratio, hemoglobin, platelet count, CRP) were analyzed. Receiver operating characteristic (ROC) curve analyses were performed to assess predictive accuracy. A novel scoring system, the Hema-PE Score, was constructed and its performance compared with existing risk models. Results: PE was identified in 35% of patients. The D-dimer/albumin ratio showed strong discriminatory power for predicting PE (AUC = 0.82). Based on multivariable predictors, the Hema-PE Score was developed (range 0–7 points). At a threshold of ≥3, the score achieved 100% sensitivity and 76% specificity (AUC = 0.88). Compared with the Khorana and ThroLy scores, the Hema-PE Score demonstrated superior predictive performance across hematologic malignancy subtypes. Conclusions: The D-dimer/albumin ratio and the newly developed Hema-PE Score demonstrated strong predictive performance for pulmonary embolism in patients with hematologic malignancies. These findings suggest that the Hema-PE Score may serve as a practical and easily applicable risk stratification tool, supporting early diagnosis and guiding thromboprophylaxis decisions in clinical practice. Prospective multicenter validation studies are warranted to confirm its utility and to facilitate its integration into patient management strategies. Full article

Background and Objectives: Hematological parameters are increasingly being investigated as readily accessible biomarkers for the diagnosis of obstructive sleep apnea syndrome (OSAS). In our study, we aimed to investigate the relationship between OSAS and albumin indices and the uric acid-to-HDL ratio (UHR). Methods: The demographic and laboratory data and AHI (apnea–hypopnea index) values of 613 patients who underwent polysomnography were obtained retrospectively from their files. Blood parameters such as white blood cells (WBCs), red blood cell distribution width (RDW), red blood cells (RBCs), hemoglobin (Hb), hematocrit (Hct), platelets (PLTs), C-reactive protein (CRP), albumin, blood urea nitrogen (BUN), and high-density lipoproteins (HDLs) were obtained from the files. Laboratory indices such as the BUN-to-albumin ratio (BAR), neutrophil-to-albumin ratio (NAR), RDW-to-albumin ratio (RAR), CRP-to-albumin ratio (CAR), and UHR were calculated. OSAS was categorized as simple snoring (SS) (control) (AHI < 5), mild (5 ≤ AHI < 15), moderate (15 ≤ AHI < 30), and severe (AHI ≥ 30). The patients were also grouped as severe (AHI ≥ 30) and non-severe (5 > AHI < 30) OSAS and compared in terms of laboratory parameters and indices. Results: Of the 613 participants, 366 (59.7%) were men, and the average age of participants was 55.22 ± 11.13 years. The biomarkers such as RBCs, Hb, Htc, CRP, BUN, creatinine, uric acid, HDLs, CAR, RAR, BAR, and UHR showed significant differences between OSAS patients and controls. WBCs, basophils, RBCs, RDW, Htc, PLTs, HDLs, uric acid, RAR, NAR, and UHR indices were significantly different between the severe OSAS and non-severe OSAS groups (p < 0.05). BAR (OR = 1.151; CI = 1.056 − 1.256; p = 0.001) and UHR (OR = 2.257; 95% CI = 1.507 − 3.382; p < 0.001) were the most important indices predicting OSAS, while RAR (OR = 1.844; CI = 1.224 − 2.778; p = 0.003) and UHR (OR = 2.203; 95% CI = 1.496 − 3.243; p < 0.001) were the strongest indices associated with severe OSAS. Conclusion: In our study, RAR, BAR, and UHR indices were closely associated with the presence and severity of OSAS. These indices can be considered low-cost, readily available methods for predicting OSAS patients. Full article

Background: The platelet-to-hemoglobin ratio (PHR) has emerged as a potential prognostic marker in various cardiovascular contexts, but its role in acute coronary syndrome (ACS), particularly among patients with diabetes mellitus (DM), remains unclear. Methods: In this retrospective cohort study, 843 ACS patients admitted to the 2nd Cardiology Department at Hippokration Hospital of Thessaloniki, Greece, between 2017 and 2023 were evaluated. PHR was calculated from admission complete blood counts. The primary endpoint was all-cause mortality during a median follow-up of 25 months. Multivariate logistic and Cox regression analyses, receiver operating characteristic (ROC) curves, Kaplan–Meier survival analyses, and restricted cubic spline (RCS) models were employed, with subgroup analyses by DM status. Results: Higher PHR was independently associated with increased mortality in the overall cohort (adjusted hazard ratio [aHR] 1.35, p < 0.001). This association showed stronger predictive value in DM patients, reflected in both a higher aHR (1.52 vs. 1.36 in non-DM patients, p < 0.001 and p = 0.018, respectively) and superior discriminative performance on ROC analysis (AUC 0.707 vs. 0.600 overall, p = 0.0006). Kaplan–Meier analysis confirmed poorer survival in high-PHR groups, especially in DM patients. RCS analysis revealed a J-shaped relationship, with risk increasing markedly beyond PHR values of 2.2. Conclusions: PHR is an independent predictor of long-term mortality in ACS, with greater prognostic significance in DM patients. Its simplicity, low cost, and availability from routine blood tests make it a promising tool for risk stratification in ACS. Full article

Background: This study aimed to evaluate the prognostic value of some novel laboratory indices in intensive care unit (ICU)-hospitalized sepsis patients. Methods: This retrospective, observational study included 400 patients with sepsis. The indices studied were the C-reactive protein/albumin ratio (CAR), hemoglobin, albumin lymphocyte, and platelet (HALP) score, lymphocyte/monocyte ratio (LMR), prognostic nutritional index (PNI), systemic immune inflammatory index (SII), vitamin B12xC-reactive protein index (BCI), systemic inflammatory response index (SIRI), and platelet/lymphocyte ratio (PLR). The predicting effects of these indices in ICU mortality, along with other clinical outcomes, were investigated. Results: The median age of the study population was 73 (18–95) years and 51.6% were males. The ICU mortality rate was 51.7%. Deceased patients with sepsis had an increased age and high APACHE II and SOFA scores compared to the survivors (p < 0.05 for all). In the multivariate logistic regression analysis, age (HR = 1.069, p = 0.038 in Model 1 vs. HR = 1.053, p = 0.001 in Model 2), SOFA score (HR = 2.145, p < 0.001 in Model 1 vs. HR = 1.740, p < 0.001 in Model 2), phosphorus levels (in Model 1, HR = 0.608, p = 0.037), and CAR (in Model 2, HR = 1.012, p = 0.023) were independent associated factors for ICU mortality. According to the ROC analyses, the SOFA (AUC = 0.879, p < 0.001) and APACHE II (AUC = 0.769, p < 0.001) scores showed high accuracy in predicting ICU mortality, while the PNI (AUC = 0.675, p < 0.001), CAR (AUC = 0.609, p < 0.001), and the BCI (AUC = 0.648, p < 0.001) showed limited accuracy. However, the HALP score did not reach a significant level in predicting ICU mortality (p = 0.067). Conclusions: Excluding the HALP score, the new laboratory indices mentioned above may be prognostic markers for predicting clinical outcomes in intensive care units for patients with sepsis. However, these indices need to be supported by larger patient populations. Full article

Background: Intensive Care Units (ICUs) provide critical support for patients after major surgery or acute abdominal conditions. Despite medical advances, mortality remains high in surgical ICU patients. This study aimed to identify clinical and biochemical predictors of mortality in surgical patients admitted to a tertiary ICU. Methods: We conducted a retrospective case–control study on 231 adult general surgery patients admitted to a tertiary anesthesia ICU between January 2018 and December 2023. Patients under 18 years or who underwent solid organ transplantation were excluded. Data collected included demographic, clinical, and laboratory parameters such as the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP)/albumin ratio. Patients were divided into mortality and survival groups, with subgroup analyses performed for malignancy, sepsis, and trauma. Receiver operating characteristic (ROC) curve and Cox regression analyses were used to identify mortality predictors. Results: The ICU mortality rate was 64.9%. Significant predictors included age ≥ 58 years (odds ratio [OR] 4.56), body mass index (BMI) > 30 kg/m² (OR 7.62), mean arterial pressure < 70 mmHg (OR 1.66), serum albumin < 21.3 g/L (OR 1.5), APACHE II > 18.5 (OR 2.42), and SOFA > 9.5 (OR 2.68). Mortality was also associated with lower GCS scores, prolonged mechanical ventilation, and inotropic support. The CRP/albumin ratio was significantly elevated in the mortality group (p = 0.024). Other inflammatory markers showed no significant differences. Predictive factors varied among subgroups. Conclusions: Older age, obesity, hypotension, hypoalbuminemia, and high severity scores independently predict mortality in surgical ICU patients. Early risk identification may enhance management and improve outcomes in this population. Full article

Background: Placenta accreta spectrum (PAS) is a serious pregnancy complication associated with significant hemorrhaging and elevated maternal morbidity. Timely prenatal diagnosis is critical for reducing the risk of adverse outcomes. In this study, we aimed to investigate the association between PAS and first-trimester maternal serum screening markers, as well as selected hematological and inflammatory indices, in pregnancies complicated by placenta previa (PP). Methods: A retrospective study was conducted at a tertiary care center. Pregnant women with singleton pregnancies who had been diagnosed with PP and undergone first-trimester aneuploidy screening and delivered at the same institution were included. The participants were divided into two groups: those diagnosed with PAS (including placenta accreta, increta, and percreta) and those with PP without placental invasion. Data on maternal demographics, the first-trimester serum levels of pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG), as well as pre-delivery complete blood count parameters, were collected. Associations between these markers and abnormal placental implantation were analyzed. Results: In total, 181 participants were included in this study, corresponding to 15 cases of PAS and 166 cases of non-invasive PP. The women in the PAS group were significantly younger than those in the non-invasive-PP group (25.3 ± 5.1 vs. 30.0 ± 6.3 years, p < 0.001). The serum levels of PAPP-A and free β-hCG were significantly higher in the PAS cases (p < 0.05). The mean platelet volume (MPV) was significantly lower inF the PAS group (p < 0.05). We did not observe any significant differences in other hematological parameters, including hemoglobin concentration, white blood cell count, neutrophil and lymphocyte counts, platelet count, red cell distribution width, and inflammatory ratios such as the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios. Conclusions: Elevated first-trimester levels of PAPP-A and β-hCG, along with a reduced MPV, may serve as early indicators of PAS in pregnancies complicated by PP. These biomarkers may assist in early risk stratification and help inform perinatal management strategies. Full article

Objectives: Hepatocellular carcinoma (HCC) remains a major indication for liver transplantation (LT), but accurate pretransplant risk stratification is critical to improve long-term outcomes. Traditional morphometric criteria such as tumor size and number are limited in predicting recurrence and survival. The HALP (hemoglobin, albumin, lymphocyte, platelet), gamma-glutamyl transpeptidase to platelet ratio (GPR), and FIB-4 indices are emerging systemic inflammatory and nutritional biomarkers that may provide additional prognostic value in HCC patients undergoing LT. Materials and Methods: This retrospective, two-center cohort study included 200 patients who underwent LT for HCC between 2012 and 2023. Preoperative HALP, GPR, and FIB-4 scores were calculated, and their associations with overall survival (OS) and recurrence-free survival (RFS) were assessed using ROC analyses and Cox proportional hazard models. Cut-off values were determined for each biomarker, and survival outcomes were analyzed using Kaplan–Meier methods. Results: A low HALP score (≤0.39) was independently associated with reduced OS but not with RFS. Conversely, low GPR (≤0.45) and FIB-4 (≤3.1) values were significantly associated with both poor OS and higher recurrence risk. Tumor size, number of lesions, and microvascular invasion also independently predicted poor outcomes. Multivariate analysis confirmed HALP, GPR, and FIB-4 as significant preoperative predictors of prognosis in this population. Conclusions: HALP, GPR, and FIB-4 are readily available, cost-effective indices that provide significant prognostic information in HCC patients undergoing LT. Their integration with morphometric criteria may improve pretransplant risk stratification and support individualized clinical decision-making. Full article

Background: Lung cancer remains the leading cause of global cancer mortality. The HALP (hemoglobin, albumin, lymphocyte, platelet) score integrates nutritional, immune, and inflammatory status and may offer prognostic value. This meta-analysis evaluates the association between the HALP score and survival outcomes in lung cancer patients. Methods: Following PRISMA guidelines, PubMed, Embase, Web of Science, CNKI, Wanfang, and Google Scholar were searched. Inclusion criteria covered observational studies in lung cancer reporting hazard ratios (HRs) for overall survival (OS), progression-free survival (PFS), or disease-free survival (DFS). Study quality was assessed via the Newcastle–Ottawa Scale (NOS). Random-effects models were used to pool HRs (95% confidence intervals [CIs]), with subgroup and sensitivity analyses used to address heterogeneity. Results: Fourteen studies (N = 10,182 patients) were included. A high HALP score predicted significantly improved OS in multivariate analysis (HR = 0.56, 95% CI: 0.46–0.69, p < 0.001), representing a 44% mortality risk reduction. The results were consistent for surgical (HR = 0.60, CI: 0.43–0.84), advanced (HR = 0.47, CI: 0.32–0.69), and all-stage subgroups. High HALP also correlated with superior PFS (multivariate HR = 0.56, CI: 0.39–0.78, p = 0.001) but not DFS (HR = 0.50, CI: 0.22–1.16, p = 0.107). Significant heterogeneity persisted (I² > 75% for OS), likely due to stage variability and non-standard HALP cutoffs. Publication bias was detected for OS studies (Egger′s p = 0.003). Conclusions: The HALP score is a low-cost, accessible prognostic biomarker for lung cancer. A high HALP score independently predicts better OS and PFS but not DFS, suggesting utility for long-term risk stratification. Standardized HALP thresholds and validation in diverse populations are needed for clinical implementation. Full article