{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:44:53Z","timestamp":1785908693860,"version":"3.56.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The HALP score is an easily accessible immunonutritional biomarker that may reflect systemic inflammation and nutritional status. This study aimed to evaluate the association of the preoperative HALP score with pathological T (pT) and N (pN) categories in patients with colon cancer. In addition, the performance of the HALP score in distinguishing between early (pT1\u20132) and advanced (pT3\u20134) T categories was investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study included 100 patients who underwent elective surgery for nonmetastatic colon cancer between December 2020 and December 2025. Patients who received neoadjuvant treatment, had M1 disease, or underwent emergency surgery because of bleeding or obstruction were excluded. The HALP score was calculated using hemoglobin, albumin, lymphocyte, and platelet values obtained from peripheral venous blood within one week before surgery. Discriminative performance was evaluated using ROC analysis, and cut-off values were determined using the Youden index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patients were evaluated in three comparison groups: in Group 1, patients with pN0 disease were compared with those with pN+ disease; in Group 2, patients with pT1\u20132\/pN0 disease were compared with all other patients; and in Group 3, patients with pT1\u20132 disease were compared with those with pT3\u20134 disease, irrespective of pN status. The discriminative performance of the HALP score was not significant in Group 1 (AUC\u00a0=\u00a00.53; 95% CI: 0.42\u20130.65; p = 0.568), whereas the AUC was 0.77 in Group 2 (95% CI: 0.64\u20130.89; p &amp;lt; 0.001) and 0.81 in Group 3 (95% CI: 0.71\u20130.92; p &amp;lt; 0.001). At the cut-off value of 55.37 determined for Groups 2 and 3, sensitivity was 55.0% and 60.0%, respectively, while specificity was 91.2% and 96.0%, respectively. These results demonstrated that Group 3 had statistically better diagnostic performance than Group 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In colon cancer, the HALP score was able to distinguish between early (pT1\u20132) and advanced (pT3\u20134) T categories, irrespective of pN status. Our findings suggest that the HALP score may serve as an adjunctive biomarker that could contribute to preoperative risk assessment in patients with colon cancer. The study findings should be validated in larger, prospective, multicenter cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1866931","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:52:30Z","timestamp":1785905550000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The role of the preoperative HALP score in predicting pathological T and N categories in colon cancer: a single-center retrospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"\u00c7a\u011fan","family":"Aykurt","sequence":"first","affiliation":[{"name":"Surgical Oncology Clinic, Ankara Bilkent City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Bal","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Ankara Bilkent City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abd\u00fclkadir","family":"\u00dcnsal","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Ankara Bilkent City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"\u00c7oban","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Ankara Bilkent City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adem","family":"Ozcan","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Ankara Bilkent City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6khan","family":"Akkurt","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Ankara Bilkent City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.12771\/emj.2023.e24","article-title":"Inflammatory response markers as predictors of colorectal cancer prognosis","volume":"46","author":"Kim","year":"2023","journal-title":"Ewha Med J"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22158002","article-title":"Inflammation-related biomarkers for the prediction of prognosis in colorectal cancer patients","volume":"22","author":"Yamamoto","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.28367","article-title":"What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP's prognostic ability in different cancer types","volume":"14","author":"Farag","year":"2023","journal-title":"Oncotarget"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.12271","article-title":"Preoperative combined hemoglobin, albumin, lymphocyte and platelet levels predict survival in patients with locally advanced colorectal cancer","volume":"7","author":"Jiang","year":"2016","journal-title":"Oncotarget"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S531116","article-title":"Hemoglobin-albumin-lymphocyte-platelet score as an integrative biomarker for prognosis and sarcopenia in colorectal cancer","volume":"18","author":"Xie","year":"2025","journal-title":"J Inflammation Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4324635","article-title":"The prognostic significance of HALP index for colon cancer patients in a Hispanic-based population","volume":"2022","author":"Calderillo Ruiz","year":"2022","journal-title":"J Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.14216\/kjco.23002","article-title":"Clinical influence of neoadjuvant chemoradiotherapy on immunonutritional status in locally advanced rectal cancer","volume":"19","author":"Lee","year":"2023","journal-title":"Korean J Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrae038","article-title":"Neoadjuvant treatment of colorectal cancer: comprehensive review","volume":"8","author":"Smith","year":"2024","journal-title":"BJS Open"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2026.1825101","article-title":"Preoperative HALP and LMR predict disease-free survival in stage III colon cancer and enable nomogram-based risk stratification","volume":"16","author":"Xu","year":"2026","journal-title":"Front Oncol"},{"key":"B10","first-page":"191","article-title":"Lymph node metastasis in T1 colorectal cancer: Risk factors and prediction model","volume":"25","author":"Fujino","year":"2023","journal-title":"Oncol Lett"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.70040","article-title":"Lymph node metastasis risk factors in T2 colorectal cancer","volume":"5","author":"Morita","year":"2025","journal-title":"Den Open"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198444","article-title":"Complete blood count reference intervals from a healthy adult urban population in Kenya","volume":"13","author":"Omuse","year":"2018","journal-title":"PloS One"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2478\/jomb-2019-0046","article-title":"Gender and age-specific reference intervals of common biochemical analytes in Chinese population: Derivation using real laboratory data","volume":"39","author":"Wang","year":"2020","journal-title":"J Med Biochem"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2022.282131","article-title":"How different are blood platelets from women or men, and young or elderly people","volume":"108","author":"De Gaetano","year":"2023","journal-title":"Haematologica"},{"key":"B15","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1038\/s41598-018-19146-y","article-title":"Prognostic significance of HALP (hemoglobin, albumin, lymphocyte and platelet) in patients with bladder cancer after radical cystectomy","volume":"8","author":"Peng","year":"2018","journal-title":"Sci Rep"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1866931\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:52:39Z","timestamp":1785905559000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1866931\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":15,"alternative-id":["10.3389\/fonc.2026.1866931"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1866931","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"article-number":"1866931"}}