The ability of HALP score to distinguish between malignant and benign colorectal neoplasms and its prognostic importance in colorectal cancers

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.