血清尿酸水平对胃癌术后辅助化疗患者预后的影响

Effect of Serum Uric Acid Level on the Prognosis of Patients with Curative Postoperative Adjuvant Chemotherapy for Gastric Cancer

目的 探讨血清尿酸(SUA)水平对根治性手术后接受5-氟尿嘧啶(5-FU)为基础辅助化疗的Ⅱ期和Ⅲ期胃癌患者的临床病理特征及预后的影响。方法 回顾性纳入2014年11月至2016年11月郑州大学第一附属医院收治的根治性手术后应用5-FU为基础辅助化疗的胃癌患者107例,根据SUA水平分为3组,比较3组患者临床病理特征和预后情况。采用Kaplan-Meier法进行单因素生存分析,采用Cox比例风险回归模型分析影响总生存期(OS)的独立预后因素。结果 3组患者的性别、血清肌酐水平、病理分期比较,差异有统计学意义(P<0.05)。单因素生存分析显示,在整体研究中,A组和C组的OS均短于B组(P<0.05)。在病理分期Ⅲ期患者中,C组的OS短于B组(P<0.05),A组的OS短于B组(P<0.05)。3组患者1 a OS分别为95.8%、91.3%、57.1%,3 a OS分别为66.7%、 73.9%、 28.6%,5 a OS分别为37.5%、 73.9%、 21.4%。在足疗程化疗患者中,A组的OS短于B组(P<0.05);与B组相比,C组OS较短,但差异无统计学意义(P=0.104)。多因素Cox回归分析显示,正常SUA水平是较长OS的预后因素(P<0.05)。结论 SUA水平对根治性手术后应用5-FU为基础辅助化疗的胃癌患者预后的影响与TNM分期密切相关。

Objective To explore the impact of serum uric acid(SUA) level on the clinicopathological characteristics and prognosis of patients with stage Ⅱ and stage Ⅲ gastric cancer treated with 5-fluorouracil(5-FU) as basic adjuvant chemotherapies after radical surgeries.Methods A total of 107 patients with gastric cancer who were treated with 5-FU-based adjuvant chemotherapy after radical surgery in the First Affiliated Hospital of Zhengzhou University from November 2014 to November 2016 were retrospectively included. They were divided into three groups according to the SUA level, and the clinicopathological characteristics and prognosis of the three groups were compared. Kaplan-Meier method was used for univariate survival analysis, and Cox proportional risk regression model was used to analyze the independent prognostic factors affecting total survival(OS).Results There were differences in sex, serum creatinine level and pathological stage among the three groups(P<0.05). Univariate survival analysis showed that the OS of group A and group C was shorter than that of group B in the overall study(P<0.05). In patients with pathological stage Ⅲ, the OS of group C was shorter than that of group B(P<0.05), and the OS of group A was shorter than that of group B(P<0.05). The 1-year OS was 95.8%, 91.3% and 57.1%, the 3-year OS was 66.7%, 73.9% and 28.6%, and the 5-year OS was 37.5%, 73.9% and 21.4%, respectively. In the patients with chemotherapy of full treatment course, the OS of group A was shorter than that of group B(P<0.05). Compared with group B, the OS of group C was shorter, but the difference was not statistically significant(P=0.104). Multivariate Cox regression analysis showed that normal SUA level was an prognostic factor for longer OS(P<0.05).Conclusion The effect of SUA level on the prognosis of gastric cancer patients treated with 5-FU-based adjuvant chemotherapy after radical surgery is closely related to TNM stage.