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. 2025 Jan 2;17(1):e76801.
doi: 10.7759/cureus.76801. eCollection 2025 Jan.

HALP (Hemoglobin, Albumin, Lymphocyte, and Platelet) Score and Its Companions in Papillary Thyroid Cancer: Can They Predict Central Lymph Node Metastasis?

Mahmut Kaan Demircioğlu  1 , Serkan Sari  2 , Mehmet Saban Korkmaz  2 , Gorkem Yildiz  2 , Sezer Akbulut  2 , Tugba Matlim Ozel  2 , Yigit Soytas  2
Affiliations

HALP (Hemoglobin, Albumin, Lymphocyte, and Platelet) Score and Its Companions in Papillary Thyroid Cancer: Can They Predict Central Lymph Node Metastasis?

Mahmut Kaan Demircioğlu et al. Cureus. .

Abstract

Background Papillary thyroid cancer (PTC) is one of the most common cancers with a favorable prognosis. The prognosis is most commonly associated with lymph node metastasis. We investigated whether there is a relationship between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and PTC central region lymph node metastasis in the preoperative period. NLR (neutrophil/lymphocyte ratio), PLR (platelet/lymphocyte ratio), MLR (monocyte/lymphocyte ratio), PIV (pan-immune-inflammation value), PNI (prognostic nutritional index), SII (systemic immune-inflammation index) were analyzed as other predictive factors for PTC central region lymph node metastasis. Methods The data of 235 patients who were operated on for PTC and underwent additional central neck dissection in our clinic were analyzed retrospectively. The effect of the HALP score, NLR, PLR, MLR, PIV, PNI, and SII values on PTC central region lymph node metastasis was analyzed with univariate and multiple logistic regression analyses. Results The HALP score, NLR, PLR, MLR, PIV, PNI, and SII had no statistically significant effect on the number of positive lymph nodes in the central region, lymphatic invasion, vascular invasion, extra-thyroidal invasion in PTC (p>0.050 for each). For PTC, stage progression was associated with a decrease in preoperative PNI (OR=0.871; p=0.019). Conclusion There was a significant negative correlation between PNI and the stage of the PTC. No significant correlation was found between the HALP score and prognostic predictors of papillary PTC central lymph node metastasis. This may be related to the fact that PTC is a type of cancer that does not affect biochemical parameters much.

Keywords: halp score; lymph node metastasis; papillary thyroid cancer; predictive factor; prognostic nutritional index (pni).

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Basaksehir Cam and Sakura City Hospital Local Ethics Committee issued approval 2023-344. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. ROC curve of parameters for predicting the presence of a metastatic central lymph node
ROC: receiver operating characteristic
See this image and copyright information in PMC

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