A novel Hemoglobin-Albumin-Lymphocyte-Platelet (HALP)-based prognostic model to predict the progression of premenopausal breast cancer: a retrospective cohort study.
- 1Department of Breast Surgery, Changzhou Medical Center, The Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Changzhou, Jiangsu, P.R. China.
- 2Department of Breast Surgery, Changzhou Medical Center, The Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Changzhou, Jiangsu, P.R. China. [email protected].
- 3Department of Breast Surgery, Changzhou Medical Center, The Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Changzhou, Jiangsu, P.R. China. [email protected].
Abstract
Background
The incidence of breast cancer is increasing annually in premenopausal patients, necessitating an improved prognostic prediction model. The hemoglobin-albumin-lymphocyte-platelet (HALP) serves as a comprehensive index that assesses systemic inflammatory response, nutritional status, and immune function.Methods
A total of 310 patients with invasive breast cancer (IBC) were enrolled, binary logistic regression and Cox multivariate analysis were applied to determine the risk factors for recurrence or metastasis, and the optimal cut-off value was determined using the Youden index. The prediction performance was compared using the Kaplan-Meier method and the area under the receiver operating characteristic curve (AUC).Results
In the premenopausal cohort, Cox multivariate analysis demonstrated that TNM stage (HR = 2.33, 95% CI: 1.264-4.28, P = 0.007), and HALP (HR = 0.25, 95%CI: 0.095-0.64, P = 0.004) were independent prognostic factors for progression-free survival (PFS). Positive epidermal growth factor receptor (EGFR) (P < 0.0001) and Cytokeratin 5/6 (CK5/6) expression (P = 0.0048), higher TNM stage (P < 0.0001), and lower HALP (P < 0.0001) were significantly associated with worse PFS. A prediction model for IBC was established based on HALP, EGFR, and CK5/6. The AUC of the combined HALP-EGFR model was 0.764, which was better than single predictive model, as well as the traditional TNM stage model. Moreover, a comprehensive model integrating TNM stage, EGFR, CK5/6, and HALP achieved an even higher AUC of 0.844.Conclusion
Our results indicate that the HALP-based prognostic model, particularly when combined with EGFR and further integrated with TNM stage and CK5/6, demonstrates high predictive value in premenopausal IBC patients, providing valuable guidance for individualized treatment.Ethics approval and registration
The study was reviewed and approved by the Ethics Committee of The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University (2018KY039_01). Date: January 1st, 2018.
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BibTeX
@article{zhang2026novel,
title = {{A novel Hemoglobin-Albumin-Lymphocyte-Platelet (HALP)-based prognostic model to predict the progression of premenopausal breast cancer: a retrospective cohort study.}},
author = {Sirui Zhang and Lingyun Xu and Wenting Peng},
journal = {BMC cancer},
year = {2026},
month = jul,
doi = {10.1186/s12885-026-16642-7},
url = {https://europepmc.org/article/MED/42928141},
note = {CC BY},
}
RIS
TY - JOUR
TI - A novel Hemoglobin-Albumin-Lymphocyte-Platelet (HALP)-based prognostic model to predict the progression of premenopausal breast cancer: a retrospective cohort study.
AU - Sirui Zhang
AU - Lingyun Xu
AU - Wenting Peng
PY - 2026
DA - 2026/07/29
JO - BMC cancer
DO - 10.1186/s12885-026-16642-7
UR - https://europepmc.org/article/MED/42928141
AB - Background The incidence of breast cancer is increasing annually in premenopausal patients, necessitating an improved prognostic prediction model. The hemoglobin-albumin-lymphocyte-platelet (HALP) serves as a comprehensive index that assesses systemic inflammatory response, nutritional status, and immune function.Methods A total of 310 patients with invasive breast cancer (IBC) were enrolled, binary logistic regression and Cox multivariate analysis were applied to determine the risk factors for recurrence or metastasis, and the optimal cut-off value was determined using the Youden index. The prediction performance was compared using the Kaplan-Meier method and the area under the receiver operating characteristic curve (AUC).Results In the premenopausal cohort, Cox multivariate analysis demonstrated that TNM stage (HR = 2.33, 95% CI: 1.264-4.28, P = 0.007), and HALP (HR = 0.25, 95%CI: 0.095-0.64, P = 0.004) were independent prognostic factors for progression-free survival (PFS). Positive epidermal growth factor receptor (EGFR) (P < 0.0001) and Cytokeratin 5/6 (CK5/6) expression (P = 0.0048), higher TNM stage (P < 0.0001), and lower HALP (P < 0.0001) were significantly associated with worse PFS. A prediction model for IBC was established based on HALP, EGFR, and CK5/6. The AUC of the combined HALP-EGFR model was 0.764, which was better than single predictive model, as well as the traditional TNM stage model. Moreover, a comprehensive model integrating TNM stage, EGFR, CK5/6, and HALP achieved an even higher AUC of 0.844.Conclusion Our results indicate that the HALP-based prognostic model, particularly when combined with EGFR and further integrated with TNM stage and CK5/6, demonstrates high predictive value in premenopausal IBC patients, providing valuable guidance for individualized treatment.Ethics approval and registration The study was reviewed and approved by the Ethics Committee of The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University (2018KY039_01). Date: January 1st, 2018.
SN - 1471-2407
ER -