Construction of prognostic assessment system of bladder cancer based on CALLY and HALP scores and its clinical value

ZHAO Yuhao; TIAN He

doi:10.3969/j.issn.1674-4136.2025.05.007

Abstract：Objective To analyze the prognostic significance of C-reactive protein,albumin and lymphocyte(CALLY)scores and hemoglobin,albumin,lymphocyte and platelet count(HALP)scores in bladder cancer.Methods Two hundred four patients with bladder cancer who were treated in Shanghai Eighth People's Hospital and Hongqi Hospital Affiliated to Mudanjiang Medical University from January 2020 to June 2022 were selected as the study subjects,and they were divided into a modeling group(n=114)and a validation group(n=90).The clinicopathological data of bladder cancer patients were collected,and Cox proportional hazard regression model was applied to analyze the risk factors affecting the progression-free-survival(PFS)of bladder cancer.Kaplan-Meier Plotter was used to analyze the level of CALLY score,HALP scores and the PFS of bladder cancer patients.Pearson's correlation analysis was performed to evaluate the correlation among CALLY scores,HALP scores,and urinary carcinoembryonic antigen(CEA).Receiver operating characteristic(ROC)curves and the Hosmer-Lemeshow(H-L)test were employed to evaluate the discriminatory ability and calibration of the scoring systems,followed by validation of the predictive model.Results The levels of CALLY scores and HALP scores were significantly correlated with muscle-invasive,pathological grade,TNM stage,and lymph node metastasis(P＜0.05),but not related to age,gender and the diameter of tumors(P＞0.05).Cox multivariate regression analysis revealed that high urinary CEA,low CALLY scores and low HALP scores were independent risk factors for poor PFS of bladder cancer(P＜0.05).The median PFS was 28.8 months for patients with high CALLY scores,which was significantly longer than 24.7 months for those with low CALLY scores(P＜0.001);The median PFS was 28.9 months for patients with high HALP scores,which was significantly longer than 25.0 months for those with low HALP scores(P＜0.001).The levels of CALLY scores and HALP scores were negatively correlated with CEA(r=-0.429,-0.462,P＜0.001).In the modeling group,the area under the ROC curve(AUC)was 0.859 and 0.904,with H-L test results of P=0.329 and 0.287,respectively.In the validation group,the AUC were 0.837 and 0.879,with H-L test results of P=0.201 and 0.206,respectively.Conclusions CALLY scores and HALP scores are predictive factors for poor prognosis of bladder cancer,and the combined detection with urinary CEA offers certain prognostic significance for bladder cancer.