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Background <p>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.</p> Methods <p>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).</p> Results <p>In the premenopausal cohort, Cox multivariate analysis demonstrated that TNM stage (HR = 2.33, 95% CI: 1.264–4.28, <i>P</i> = 0.007), and HALP (HR = 0.25, 95%CI: 0.095–0.64, <i>P</i> = 0.004) were independent prognostic factors for progression-free survival (PFS). Positive epidermal growth factor receptor (EGFR) (<i>P</i> &lt; 0.0001) and Cytokeratin 5/6 (CK5/6) expression (<i>P</i> = 0.0048), higher TNM stage (<i>P</i> &lt; 0.0001), and lower HALP (<i>P</i> &lt; 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.</p> Conclusion <p>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.</p> Ethics approval and registration <p>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.</p>

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A novel Hemoglobin-Albumin-Lymphocyte-Platelet (HALP)-based prognostic model to predict the progression of premenopausal breast cancer: a retrospective cohort study

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  • 发表日期：

    2026年7月29日

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  • Sirui Zhang,
  • Lingyun Xu,
  • Wenting Peng

摘要

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.