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Systemic Inflammation Response Index, Albumin, and Hemoglobin-Albumin-Lymphocyte-Platelet Score for Stage-Stratified
Yadan Li1, Yanfang Cui1, Minmin Liu2
1Department of Clinical Laboratory, Shandong Medical and Pharmaceutical University Hospital, Binzhou, Shandong, 256603, People's Republic of China.
Introduction:
Inflammation- and nutrition-associated biomarkers have received increasing interest in esophageal cancer research. Nevertheless, the diagnostic value of the systemic inflammation response index (SIRI), albumin (ALB), and hemoglobin-albumin-lymphocyte-platelet (HALP) score across different pathological stages has not yet been fully clarified. We evaluated the performance of SIRI, ALB, and HALP, alone and in combination, for the auxiliary discrimination of esophageal cancer (EC), and examined their associations with clinicopathological characteristics in stage-stratified analyses.
Methods:
This retrospective study enrolled 168 esophageal cancer patients and 117 healthy controls (HC). SIRI and HALP were calculated preoperatively from routine hematological parameters. Cancer cases were divided into stage I/II (n = 32) and stage III/IV (n = 136) groups. ROC curve analysis evaluated the discriminatory efficacy of SIRI, ALB, HALP, and their combined model. The combined model was constructed using binary logistic regression incorporating SIRI, ALB, and HALP, and its discriminatory performance was evaluated by ROC analysis. Multivariable logistic regression adjusted for age and sex was performed, and bootstrap internal validation (1000 resamples) assessed model optimism.
Results:
Compared with healthy controls, patients with esophageal cancer exhibited significantly increased SIRI levels and significantly decreased ALB and HALP levels. The combined model achieved an AUC of 0.803 for distinguishing stage III/IV disease from healthy controls and 0.746 for stage I/II disease. SIRI was significantly associated with T stage and N stage. ALB with tumor length and T stage. HALP with smoking history and T stage. After adjustment for age and sex, HALP retained significance mainly in the all-cancer and stage III/IV analyses.
Conclusion:
SIRI, ALB, and HALP were associated with the occurrence and stage of esophageal cancer. Their combined model demonstrated improved discriminatory performance over single markers, particularly in stage III/IV disease, and retained additional value after adjustment for age and sex. These biomarkers may serve as convenient exploratory indicators for auxiliary assessment of esophageal cancer.
