BMC cancer · 2026
A novel "early warning" system for biochemical recurrence in prostate cancer: development and validation of the SII-HALP combined score.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Yujie, Fu Guangqing, Han Dengjun, Ye Dayong
Аннотация
BACKGROUND: Traditional clinicopathological features often inadequately reflect systemic host-tumor dynamics, compromising the predictive accuracy of biochemical recurrence (BCR) in prostate cancer, particularly with respect to early oncological failure. This study sought to evaluate the SII-HALP combined score-integrating the Systemic Immune-Inflammation Index (SII) and Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score-and assess its time-dependent prognostic value in patients undergoing radical prostatectomy.
METHODS: Clinicopathological data from patients with localized prostate cancer were retrospectively analyzed. Maximally selected rank statistics identified optimal threshold values for SII and HALP. A prognostic nomogram incorporating the combined score was then constructed. Model performance was assessed using time-dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). The incremental predictive value was quantified via integrated discrimination improvement (IDI) and net reclassification improvement (NRI).
RESULTS: Multivariable Cox regression established the SII-HALP combined score as an independent predictor of BCR. The nomogram exhibited an improved predictive performance for 1-year recurrence (AUC 0.866 vs. 0.821 in the base model; P = 0.002). This incremental gain was confirmed by an IDI of 0.067 (P < 0.001) and an NRI of 0.532 (P = 0.040). While the incremental benefit diminished at exploratory 3- and 5-year timepoints as anatomical factors became predominant, DCA indicated a superior net benefit at 1 year across most threshold probabilities, and tentatively at higher thresholds (> 50%) for exploratory long-term projections.
CONCLUSION: Based on internal validation, the preliminary SII-HALP combined score may serve as an exploratory, low-cost prognostic tool that contributes to optimizing risk stratification for 1-year biochemical recurrence. Reflecting a possible host-tumor biological interaction, it offers a conceptual pathway for individualized risk triage, pending further robust external validation and extended longitudinal follow-up.
METHODS: Clinicopathological data from patients with localized prostate cancer were retrospectively analyzed. Maximally selected rank statistics identified optimal threshold values for SII and HALP. A prognostic nomogram incorporating the combined score was then constructed. Model performance was assessed using time-dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). The incremental predictive value was quantified via integrated discrimination improvement (IDI) and net reclassification improvement (NRI).
RESULTS: Multivariable Cox regression established the SII-HALP combined score as an independent predictor of BCR. The nomogram exhibited an improved predictive performance for 1-year recurrence (AUC 0.866 vs. 0.821 in the base model; P = 0.002). This incremental gain was confirmed by an IDI of 0.067 (P < 0.001) and an NRI of 0.532 (P = 0.040). While the incremental benefit diminished at exploratory 3- and 5-year timepoints as anatomical factors became predominant, DCA indicated a superior net benefit at 1 year across most threshold probabilities, and tentatively at higher thresholds (> 50%) for exploratory long-term projections.
CONCLUSION: Based on internal validation, the preliminary SII-HALP combined score may serve as an exploratory, low-cost prognostic tool that contributes to optimizing risk stratification for 1-year biochemical recurrence. Reflecting a possible host-tumor biological interaction, it offers a conceptual pathway for individualized risk triage, pending further robust external validation and extended longitudinal follow-up.