血清尿酸水平与结肠癌淋巴结转移的关系

RELATIONSHIP BETWEEN SERUM URIC ACID LEVEL AND LYMPH NODE METASTASIS OF COLON CANCER

目的探讨血清尿酸(UA)水平评估结肠癌病人淋巴结转移的价值。方法对857例经病理明确诊断为结肠癌病人的临床资料进行分析,应用Spearman及二元Logistic回归分析方法分析结肠癌淋巴结转移相关因素,应用受试者工作特征(ROC)曲线分析血UA作为结肠癌转移评估指标的灵敏度和特异度。结果857例结肠癌病人中男性540例,伴有淋巴结转移114例(21.11%);女性317例,伴有淋巴结转移78例(24.61%)。单因素相关分析显示,结肠癌病人淋巴结转移与血清UA水平、肿瘤直径、癌胚抗原水平、血肌酐(Cr)水平相关(Z=-5.291~4.080,P<0.05)。二元Logistic回归分析显示,UA水平、肿瘤直径、癌胚抗原水平是影响结肠癌淋巴结转移的独立危险因素(OR=0.922~1.007,P<0.05)。血清UA水平评估结肠癌淋巴结转移的ROC曲线下面积为0.764,截断值为222.55μmol/L时诊断灵敏度为72.4%,特异度为65.6%。结论血清UA水平是影响结肠癌病人淋巴结转移的独立危险因素,血清UA水平检测可能对结肠癌病人肿瘤转移的评估起到一定作用。

Objective To investigate the value of serum uric acid(UA)level in evaluating lymph node metastasis in colon cancer patients.Methods An analysis was performed on the clinical data of 857 patients with pathologically confirmed colon cancer.Spearman and binary logistic regression tests were used to analyze the factors related to lymph node metastasis of colon cancer.Receiver operating characteristic(ROC)curves were used to analyze the sensitivity and specificity of serum UA level as the assessment indicator of colon cancer metastasis.Results Among the 857 patients with colon cancer,540 were male,of whom 114(21.11%)were with lymph node metastasis;317 were female,of whom 78(24.61%)were with lymph node metastasis.Univariate regression analysis showed that lymph node metastasis in colon cancer patients was associated with serum UA level,tumordiameter,carcinoembryonic antigen level,and serum creatinine level(Z=-5.291-4.080,P<0.05).Binary logistic regression analysis showed that serum UA level,tumor diameter,and carcinoembryonic antigen level were independent risk factors for lymph node metastasis of colon cancer(odds ratio=0.922-1.007,P<0.05).The area under the ROC curve of serum UA level for assessing lymph node metastasis of colon cancer was 0.764,with diagnostic sensitivity and specificity of 72.4%and 65.6%,respectively,when using 222.55μmol/L as a cut-off value.Conclusion Serum UA level is an independent risk factor for lymph node metastasis in colon cancer patients.The measurement of serum UA level may play a role in evaluating tumor metastasis in colon cancer patients.