Haemoglobin,albumin,lymphocyte and platelet predicts postoperative survival in pancreatic cancer

BACKGROUND Systemic inflammation and nutrition status play an important role in cancer metastasis.The combined index of hemoglobin,albumin,lymphocyte,and platelet(HALP),consisting of haemoglobin,albumin,lymphocytes,and platelets,is considered as a novel marker to reflect both systemic inflammation and nutrition status.However,no studies have investigated the relationship between HALP and survival of patients with pancreatic cancer following radical resection.AIM To evaluate the prognostic value of preoperative HALP in pancreatic cancer patients.METHODS The preoperative serum levels of hemoglobin,albumin,lymphocyte counts,and platelet counts were routinely detected in 582 pancreatic adenocarcinoma patients who underwent radical resection.The relationship between postoperative survival and the preoperative level of HALP was investigated.RESULTS Low levels of HALP were significantly associated with lymph node metastasis(P=0.002),poor tumor differentiation(P=0.032),high TNM stage(P=0.008),female patients(P=0.005)and tumor location in the head of the pancreas(P<0.001).Low levels of HALP were associated with early recurrence[7.3 mo vs 16.3 mo,P<0.001 for recurrence-free survival(RFS)]and short survival[11.5 mo vs 23.6 mo,P<0.001 for overall survival(OS)]in patients with resected pancreatic adenocarcinoma.A low level of HALP was an independent risk factor for early recurrence and short survival irrespective of sex and tumor location.CONCLUSION Low levels of HALP may be a significant risk factor for RFS and OS in patients with resected pancreatic cancer.

Preoperative maximal voluntary ventilation,hemoglobin,albumin,lymphocytes and platelets predict postoperative survival in esophageal squamous cell carcinoma

BACKGROUND Preoperative pulmonary function plays an important role in selecting surgical candidates and assessing postoperative complications.Reduced pulmonary function is associated with poor survival in several cancers,but the prognostic value of preoperative pulmonary function in esophageal squamous cell carcinoma(ESCC)is unclear.Nutritional and systemic inflammation parameters are vital to cancer survival,and the combination of these parameters improves the prognostic value.The hemoglobin,albumin,lymphocytes and platelets(HALP)score is a novel prognostic indicator to reflect the nutritional and inflammation status,but the clinical effects of the HALP score combined with maximal voluntary ventilation(MVV),an important parameter of pulmonary function,have not been well studied in ESCC.AIM To investigate the prognostic value of MVV and HALP score for assessing postoperative survival of ESCC patients.METHODS Data form 834 ESCC patients who underwent radical esophagectomy with R0 resection were collected and retrospectively analyzed.Preoperative MVV and HALP data were retrieved from medical archives.The HALP score was calculated by the formula:Hemoglobin(g/L)×albumin(g/L)×lymphocytes(/L)/platelets(/L).The optimal cut-off values of MVV and HALP score were calculated by the receiver operating characteristic curve analysis.The Kaplan-Meier method with log-rank test was used to draw the survival curves for the variables tested.Multivariate Cox proportional hazard regression models were used to analyze the independent prognostic factors for overall survival.RESULTS MVV was significantly associated with gender(P<0.001),age at diagnosis(P<0.001),smoking history(P<0.001),drinking history(P<0.001),tumor length(P=0.013),tumor location(P=0.037)and treatment type(P=0.001).The HALP score was notably associated with gender(P<0.001),age at diagnosis(P=0.035),tumor length(P<0.001)and invasion depth(P=0.001).Univariate Cox regression analysis showed that low MVV and low HALP score were associated with worse overall survival(all P<0.001).Multivariate analysis showed that low MVV and the HALP score were both independent risk factors for overall survival(all P<0.001).The combination of MVV and HALP score improved the prediction performance for overall survival than tumor-node-metastasis.Also,low combination of MVV and HALP score was an independent risk factor for poor overall survival(P<0.001).CONCLUSION MVV,HALP score and their combination are simple and promising clinical markers to predict overall survival of ESCC patients.

Significance of preoperative peripheral blood neutrophil-lymphocyte ratio in predicting postoperative survival in patients with multiple myeloma bone disease

BACKGROUND The neutrophil-lymphocyte ratio(NLR)is often used to predict a poor prognosis in patients with tumors.This study investigated the preoperative peripheral blood NLR in predicting postoperative survival(POS)in patients with multiple myeloma bone disease(MMBD).AIM To evaluate whether NLR can be used to predict the prognosis of MMBD patients after surgery.METHODS The clinical data of 82 MMBD patients who underwent surgical treatments in Beijing Chao-yang Hospital were collected.The NLR was obtained from the absolute number of neutrophils and lymphocytes,calculated by the number of neutrophils and divided by the number of lymphocytes.The peripheral blood lymphocyte percentage was used as the major marker to analyze the change in characteristics of the immune statuses of multiple myeloma patients.RESULTS The NLR cut-off values of NLR≥3 patients and NLR≥4 patients were significantly correlated with POS.The 3-and 5-year cumulative survival rates of the high NLR group(NLR≥3 patients)were 19.1%and 0.0%,respectively,which were lower than those of the low NLR group(NLR<3 patients)(67.2%and 48.3%)(P=0.000).In the high NLR group,POS(14.86±14.28)was significantly shorter than that in the low NLR group(32.68±21.76).Univariate analysis showed that the lymphocyte percentage 1 wk after the operation(19.33±9.08)was significantly lower than that before the operation(25.72±11.02).Survival analysis showed that postoperative chemotherapy,preoperative performance status and preoperative peripheral blood NLR≥3 were independent risk factors for POS.CONCLUSION The preoperative peripheral blood NLR can predict POS in MMBD patients.MMBD patients with a high preoperative NLR(NLR≥3)showed poor prognosis.