Can the HALP Score Enhance Cancer Prediction in Thyroid Nodule Assessment?

Abstract

Background Surgical intervention typically targets malignant thyroid nodules, while benign ones are monitored unless they grow excessively. Cancer progression is influenced by tumor type and the patient's nutritional and immune status. Inflammatory cells and immune responses are crucial for prognosis. Markers like the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index predict malignancy. The HALP (Hemoglobin, Albumin, Lymphocyte, Platelet) score has shown promise as a prognostic indicator in various cancers but remains unstudied for thyroid nodules. Methods This retrospective study examined 182 patients who underwent thyroid surgery between May 2019 and February 2023. Exclusions included patients under 18, those with additional malignancies or autoimmune diseases, and those with incomplete data. HALP scores were calculated preoperatively and compared with postoperative pathology results. Results Histopathology revealed 74.7% benign and 25.3% malignant nodules. The median HALP score was higher in benign cases (44.4) than in malignant ones (40.4), with significant predictive value for malignancy (p < 0.001). ROC analysis indicated an area under the curve of 0.672 for HALP scores, suggesting moderate diagnostic accuracy. Conclusion The HALP score could serve as a cost-effective tool for differentiating benign from malignant thyroid nodules preoperatively. Its integration into clinical protocols may enhance decision-making and reduce unnecessary surgeries.