老年前列腺癌患者血清尿酸水平变化及临床意义

Changes in serum uric acid levels in elderly patients with prostate cancer and their clinical significance

目的探讨血清尿酸水平在老年前列腺癌患者与前列腺增生患者之间是否存在差异。方法本研究回顾性分析2010年2月至2019年6月在商丘市第一人民医院诊断为前列腺癌的患者300例,同期诊断为前列腺增生患者240例,前列腺大小正常的老年男性400例作为对照组,检测3组患者血清尿酸水平、血清前列腺特异性抗原(PSA)、C反应蛋白(CRP)、中性粒细胞计数(Neu)、淋巴细胞计数(Lym);观察前列腺癌患者不同临床病理特征时血清尿酸浓度。结果前列腺癌组CRP水平、Neu/Lym明显高于前列腺增生组和对照组,差异有统计学意义(均P<0.05),前列腺癌组尿酸水平为(327.0±58.3)μmol/L、前列腺增生组为(375.2±68.4)μmol/L、对照组尿酸水平为(377.8±73.2)μmol/L,前列腺癌组尿酸水平明显低于前列腺增生组和对照组(F=55.69,P<0.001);多因素Logistic回归结果显示,血清尿酸是前列腺癌发生的保护因素(OR=0.593,95%CI:0.542~0.718,P=0.004)。不同年龄、病理分级的前列腺癌患者尿酸水平差异具有统计学意义(t=-4.63、F=12.73,均P<0.001),但血清尿酸水平与前列腺癌患者临床分期、是否淋巴结转移无明显相关性(F=-2.72、t=0.77,P=0.068、0.460)。结论与前列腺增生患者和正常男性相比,前列腺癌患者血清尿酸浓度降低,而炎性标志物水平升高,表明血清尿酸可能为老年前列腺癌患者发生和发展的危险因素。

Objective To investigate differences in serum uric acid levels between elderly patients with prostate cancer and patients with benign prostatic hyperplasia(BPH).Methods A total of 300 prostate cancer patients admitted to the urology department of our hospital between Feb.2010 and Jun.2019 were retrospectively analyzed.During the same period,240 BPH patients and 400 elderly men with normal prostate size were enrolled as the control group.Serum uric acid and prostate-specific antigen(PSA)levels,C-reactive protein(CRP),neutrophil count and lymphocyte count were determined.Serum uric acid concentrations were monitored in prostate cancer patients with different clinicopathological characteristics.Results CRP and Neu/Lym levels were higher in the prostate cancer group than in the BPH and control groups(P<0.05).The serum uric acid level was(327.0±58.3)μmol/L in the prostate cancer group,lower than in the BPH group(375.2±68.4)μmol/L and the control group(377.8±73.2)μmol/L(F=55.69,P<0.001).Multivariable Logistic regression analysis indicated that serum uric acid was a protective factor for prostate cancer(OR=0.593,95%CI:0.542-0.718,P=0.004).There were significant differences in serum uric acid levels between prostate cancer patients with different ages and pathological grades(t=-4.63,F=12.73,P<0.001).However,serum uric acid levels were not significantly correlated with clinical staging or lymph node metastasis(F=-2.72 and 0.77,P=0.068 and 0.460).Conclusions Compared with BPH patients and healthy males,serum uric acid levels are reduced and inflammatory markers are increased in prostate cancer patients,indicating that serum uric acid may be a risk factor for the occurrence and progression of prostate cancer in the elderly.