Diagnostic performance of the haemoglobin–albumin–lymphocyte–platelet (‘HALP’) score and systemic inflammatory indices in differentiating malignant from benign thyroid lesions

OBJECTIVE: To evaluate systemic inflammatory indices as predictors of thyroid malignancy. METHODS: Of 316 thyroidectomy patients, 186 had benign and 130 had malignant histopathology. Pre-operative inflammatory indices, including haemoglobin-albumin-lymphocyte-platelet score, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index and systemic inflammatory response index, were compared. Logistic regression identified independent predictors after age and sex adjustment. Receiver operating characteristic analysis assessed diagnostic performance. Platelet-to-lymphocyte ratio (area under the curve = 0.696) and haemoglobin-albumin-lymphocyte-platelet score (area under the curve = 0.689) showed the highest, albeit limited, diagnostic performance. CONCLUSION: Systemic inflammatory indices, particularly haemoglobin-albumin-lymphocyte-platelet score and systemic immune-inflammation index, may aid pre-operative risk stratification as adjunctive biomarkers of thyroid malignancy.