目的 探讨治疗前血红蛋白-白蛋白-淋巴细胞-血小板评分(HALP 评分)对接受根治性放疗的食管鳞状细胞癌 (ESCC)患者总生存(OS)期的预测价值,并构建列线图模型以评估其预测效能。 方法 回顾性分析 2012 年 3 月至 2018 年 11 月四川省肿瘤医院收治的 246 例Ⅲ或Ⅳ期 ESCC 患者资料,计算治疗前 HALP 评分,采用 X-tile 确定最佳截断点。 分析 HALP 评分与临床病理特征的相关性,采用 Kaplan-Meier 法和 Cox 比例风险回归模型评估预后因素,构建列线图并验证其预测性 能。 结果 低 HALP 评分组与更晚的 T 分期、N 分期和临床分期显著相关(P < 0. 05)。 高 HALP 评分组 1 年、3 年、5 年 OS 率 均显著优于低 HALP 评分组(74. 7%比 54. 0%,46. 6%比 25. 6%,36. 9%比 19. 8%,P < 0. 001)。 多因素 Cox 比例风险回归模型 分析显示饮酒史、T 分期和 HALP 评分是 OS 的独立预后因素(P < 0. 05)。 列线图模型预测 OS 的 C-index 为 0. 687,预测效能 良好,校准曲线图显示预测准确性较高。 结论 治疗前 HALP 评分是根治性放疗 ESCC 患者 OS 的独立不良预后因素,基于 HALP 评分的列线图模型可为个体化预后评估提供参考。

Objective To investigate the predictive value of the pre-treatment hemoglobin-albumin-lymphocyte-platelet HALP score for overall survival in patients with esophageal squamous cell carcinoma ESCC undergoing radical radiotherapy and to construct a nomogram model to evaluate its predictive performance. Method A retrospective analysis was conducted on 246 patients with stage Ⅲ/ Ⅳ ESCC admitted to Sichuan Cancer Hospital from March 2012 to November 2018. The pre-treatment HALP score was calculated and the optimal cutoff value was determined using X - tile. The correlation between HALP and clinicopathological features was analyzed. Prognostic factors were assessed using the Kaplan-Meier method and Cox regression models. A nomogram was constructed and its predictive performance was validated. Result The low HALP group was significantly associated with more advanced T stage N stage and clinical stage P < 0. 05 . The high HALP group showed significantly better 1- 3- and 5-year overall survival rates compared to the low HALP group 74. 7% vs 54. 0% 46. 6% vs 25. 6% 36. 9% vs 19. 8% P < 0. 001 . Multivariate Cox proportional hazards regression model analysis identified drinking history T stage and HALP as independent prognostic factors for overall survival P < 0. 05 . The nomogram model for predicting overall survival had a C - index of 0. 687 demonstrating good predictive performance and calibration plots indicated high predictive accuracy. Conclusion A low pre-treatment HALP score is an independent poor prognostic factor for overall survival in ESCC patients undergoing radical radiotherapy. The HALP-based nomogram model may provide a reference for individualized prognostic assessment.