Predictive value of 18F-FDG PET/CT metabolic parameters combined with the HALP score for the prognosis of patients with cervical squamous carcinoma

This study aimed to investigate the predictive value of 18 F-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) parameters combined with the hemoglobin-albumin-lymphocyte-platelet (HALP) index for detecting recurrence or progression in patients with cervical squamous cell carcinoma. This was a retrospective analysis of the metabolic parameters and clinical data of 77 patients with cervical squamous carcinoma at Sichuan Cancer Hospital between November 2019 and August 2022, all of whom underwent 18F-FDG PET/CT examination, tumor marker analysis and laboratory tests within 2 weeks before treatment. The optimal cutoff values for each parameter were determined via receiver operating characteristic (ROC) curves. Between-group comparisons were performed via the chi-square test, with significant parameters subsequently included in Cox regression analysis to identify independent predictors. Kaplan‒Meier survival curves were generated to compare survival outcomes between groups. Among the 77 patients, 25 experienced disease progression or recurrence. ROC analysis revealed that glycoantigen 125 (CA125), the hemoglobin-albumin-lymphocyte-platelet (HALP) score, the maximum diameter of the tumor on PET transverse images (Dmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), the maximum standardized uptake value ratio of the spleen to the liver (SLRmax), and the mean standardized uptake value ratio of the spleen to the liver (SLRmean) were significant predictors of recurrence or progression in cervical cancer patients ( P < 0.05). The chi-square test revealed that FIGO stage, CA125 level, HALP score, Dmax, MTV, TLG, SLRmax, and SLRmean were significantly associated with patient prognosis ( P < 0.05). Multivariate Cox regression analysis revealed that FIGO stage ( P = 0.009), HALP score ( P = 0.038), and SLRmean ( P = 0.002) were independent predictors of prognosis. Notably, there were statistically significant differences in progression-free survival (PFS) among the three risk groups (high, intermediate, and low) based on the combined model ( P < 0.001). Furthermore, the combination model demonstrated superior predictive performance compared with the individual indicators. The FIGO stage, the HALP score, and the SLRmean are important indicators for predicting recurrence or progression after concurrent chemoradiotherapy (CCRT) in patients with cervical squamous cell carcinoma, and the combined model enhances the predictive efficacy of PFS.