Hailun Xie,1,2,* Lishuang Wei,3,* Shuangyi Tang,4 Jialiang Gan2,5 

1Department of Gastrointestinal and Gland Surgery, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 2Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi, People’s Republic of China; 3Department of Geriatric Respiratory Disease Ward, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 4Department of Pharmacy, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 5Department of Colorectal and Anal Surgery, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Shuangyi Tang, Department of Pharmacy, the First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, 530021, People’s Republic of China, Email tshy369@sina.com Jialiang Gan, Department of Colorectal and Anal Surgery, the First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, 530021, People’s Republic of China, Tel +86-13878155172, Email gjl5172@163.com
摘要

研究目的：本研究旨在全面探讨反映患者炎症与营养综合状态的血红蛋白-白蛋白-淋巴细胞-血小板（HALP）评分与结直肠癌（CRC）患者无进展生存期（PFS）、总生存期（OS）及肌少症之间的剂量-反应关系。

方法：对1,441例接受手术治疗的结直肠癌患者进行回顾性分析。HALP评分计算公式为血红蛋白（g/L）×白蛋白（g/L）×淋巴细胞计数（10⁹/L）/血小板计数（10⁹/L）。采用Kaplan-Meier曲线和Cox回归分析进行生存分析，并运用逻辑回归分析HALP评分与肌少症的关系。基于HALP评分构建预测模型，用于预测1年和5年PFS及OS。

研究结果：Kaplan-Meier分析显示，低HALP评分患者无进展生存期（PFS）更差（51.2%vs 63.3%，p<0.001），总生存期（OS）也更短（54.1%vs 66.0%，p<0.001）。HALP评分每增加一个标准差，PFS风险比下降13.3%（HR=0.867,95%CI=0.780–0.963，p=0.008），OS风险比下降15.2%（HR=0.848,95%CI=0.759–0.948，p=0.004）。多变量Cox回归分析证实HALP是PFS和OS的独立预后因素。逻辑回归分析表明，低HALP评分是肌少症的独立预测因子（OR=0.550,95%CI=0.420–0.963，p<0.001）。基于HALP的预测模型显示其预后预测能力强劲，PFS和OS的C指数分别为0.726和0.728,5年AUC均超过0.76。

结论：低HALP评分是结直肠癌患者PFS、OS和肌少症的独立风险因素，凸显HALP在结直肠癌临床管理中的应用潜力，有助于制定个性化治疗方案。