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    Can HALP (Hemoglobin, albumin, lymphocyte, and platelet) score distinguish malignant and benign causes of extrahepatic cholestasis in patients with extrahepatic bile duct obstruction?
    (Kare Publishing, 2024) Dusunceli, Ibrahimhalil; Sargin, Zeynep Gok; Celik, Umut; Sargin, Fatih
    OBJECTIVE: Cholestatic diseases are common and classified as benign or malignant based on their etiology. HALP is a unique nutritional immune marker that combines indicators of nutritional status, including hemoglobin and albumin, with immune function markers like lymphocyte and platelet counts. We investigated the HALP score’s ability to differentiate between benign and malignant causes in extrahepatic cholestasis patients. METHODS: This research was designed as cross-sectional and retrospective. Between 1 January 2020–1 January 2022, patients diagnosed with extrahepatic cholestasis were included. The diagnoses were confirmed using non-invasive imaging meth-ods, ERCP (endoscopic retrograde cholangiopancreatography), and tissue biopsy results. Based on the type of extrahepatic biliary obstruction, either benign or malignant, the patients were divided into two groups. The HALP score was calculated by multiplying the patient’s albumin (g/L), hemoglobin (g/L), and lymphocyte count (/L) and dividing by the platelet count (/L). RESULTS: In 121 of 216 patients, extrahepatic cholestasis was caused by benign factors, mostly choledocholithiasis, while malignant causes, predominantly pancreatic head cancer, were responsible for extrahepatic cholestasis in 95 patients. The malignant cholestasis group had significantly higher bilirubin levels (p<0.001), lower hemoglobin levels (p=0.005), lower albumin levels (p<0.001), higher lymphocyte counts (p<0.001), and higher platelet levels (p=0.001) compared to the benign cholesta-sis group. There was no considerable difference in the HALP score between the two groups, as indicated by a p-value of 0.741. CONCLUSION: The HALP score could not distinguish between benign and malignant causes of extrahepatic cholestasis. © 2024, Kare Publishing. All rights reserved.
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    The ability of HALP score to distinguish between malignant and benign colorectal neoplasms and its prognostic importance in colorectal cancers
    (2023) Dusunceli, Ibrahimhalil; Sargın, Zeynep Gök; Celik, Umut; Sargın, Fatih
    Systemic inflammation and nutritional status play important roles in the development and progression of various cancers, including colorectal cancer. The prognosis for malignancies can be predicted using the inflammatory marker known as HALP (calculated by hemoglobin, albumin, lymphocytes, and platelets). Furthermore, recent studies have claimed the HALP score to help distinguish between benign and malignant lesions. We aimed to research the diagnostic importance of the HALP score in the differentiation of malignant (colorectal cancer) and benign colorectal neoplasms (colorectal adenomas and hyperplastic polyps) and its prognostic significance in colorectal cancer patients. Patients diagnosed with colorectal cancer, colorectal adenoma, and hyperplastic polyps were evaluated retrospectively between January 2017 and January 2022. The median HALP score in the colorectal cancer group was significantly lower than the other groups (colorectal adenoma and hyperplastic polyps) (p<0.001). There was no statistical difference between the median HALP scores of the colorectal adenoma and hyperplastic groups (p=0.525). ROC analysis found the cut-off value of the HALP score as 41.01 to differentiate colorectal cancer from benign colorectal lesions (sensitivity= 0.73, specitivity=0.62, 95% CI=0.67-0.76, p<0.001). The HALP level below 28.1 was associated with worse overall survival (p=0.046) and was shown to be an independent prognostic factor in the colorectal cancer group. The HALP score can be used to differentiate colorectal cancer from benign colorectal neoplasms and as a prognostic factor in colorectal cancer.