Metastatik küçük hücreli akciğer kanserinde kan temelli öngördürücüler olarak HALP ve SII

Abstract

Gerekçe/Amaç Küçük hücreli akciğer kanseri (SCLC), sınırlı sağkalım süresiyle seyreden agresif bir malignitedir ve kolay ulaşılabilir prognostik belirteçlere duyulan ihtiyacı ortaya koymaktadır. Bu çalışma, Hemoglobin, Albümin, Lenfosit ve Trombosit (HALP) skoru ile Sistemik İmmün-İnflamasyon İndeksi’nin (SII) SCLC hastalarındaki prognostik değerini değerlendirmeyi amaçlamıştır. Yöntem Metastatik SCLC tanısı almış 132 hasta retrospektif olarak analiz edilmiştir. Başlangıç laboratuvar verileri kullanılarak HALP ve SII skorları hesaplanmıştır. ROC analizi ile optimal kesim değerleri belirlenmiştir. Sağkalım sonuçları Kaplan–Meier ve Cox regresyon analizleriyle değerlendirilmiştir. Bulgular HALP için optimal kesim değeri 17,23; SII için 747,27 olarak bulunmuştur. Yüksek SII düzeyi, progresyonsuz sağkalımın (PFS) daha kısa olmasının bağımsız bir öngördürücüsü olarak saptanmıştır (HR = 1,82, p = 0,04), ancak genel sağkalımı (OS) öngörmemiştir. HALP, 6 aylık sağkalımı öngörmede anlamlı bulunmuştur (AUC: 0,61, p = 0,04), ancak OS veya PFS üzerinde anlamlı bir etkisi gözlenmemiştir. Karaciğer (HR = 1,72, p = 0,04) ve beyin metastazı (HR = 1,74, p = 0,02) varlığı, PFS’nin daha kısa olmasının bağımsız belirteçleri olarak belirlenmiştir. Sonuç SII, SCLC hastalarında PFS için güvenilir bir prognostik belirteç olabilirken, HALP sınırlı bir öngörü gücüne sahiptir. Özellikle karaciğer ve beyin metastazlarının varlığı prognozu anlamlı şekilde etkilemektedir. Bu bulguların doğrulanması için daha geniş ve prospektif çalışmalara ihtiyaç vardır.

Keywords

• küçük hücreli akciğer kanseri
• Sistemik immün-inflamasyon indeksi
• HALP skoru

HALP and SII as blood-based predictors in metastatic small-cell lung cancer

Abstract

Aims: Small cell lung cancer (SCLC) is an aggressive malignancy with limited survival, underscoring the need for accessible prognostic markers. This study aimed to evaluate the prognostic value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the Systemic Immune-inflammation Index (SII) in patients with SCLC. Methods: We retrospectively analyzed 132 patients diagnosed with metastatic SCLC. Baseline laboratory data were used to calculate HALP and SII scores. Optimal cut-off values were determined by ROC analysis. Survival outcomes were assessed using Kaplan-Meier and Cox regression analyses. Results: The optimal cut-off values were 17.23 for HALP (AUC: 0.611, 95% CI: 0.50-0.72, p=0.04) and 747.27 for SII (AUC: 0.628, p=0.02, 95% CI: 0.52–0.73). High SII was an independent predictor of shorter progression-free survival (PFS) (HR=1.82, 95% CI: 1.02–3.26, p=0.04), but not overall survival (OS). HALP score predicted 6-month survival but showed no significant effect on OS or PFS. Liver (HR=1.72, 95% CI: 1.02-2.90, p=0.04) and brain metastases (HR=1.74, 95% CI: 1.08-2.80, p=0.02) were independent predictors of shorter PFS. Conclusion: SII may serve as a reliable prognostic marker for PFS in SCLC, while HALP showed limited predictive value. Metastatic sites, particularly liver and brain involvement, significantly impact prognosis. Larger, prospective studies are needed to validate these findings.

Keywords

• Small cell lung cancer
• Systemic Immune-inflammation Index
• HALP score

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