术前血清尿酸及其列线图模型在根治性膀胱切除术患者预后中的价值

The value of preoperative serum uric acid and its nomogram model in the prognosis of patients undergoing radical cystectomy

目的:探究术前血清尿酸(SUA)水平与根治性膀胱切除术(RC)患者总生存时间(OS)的关系,并构建预测RC患者术后OS率的列线图(Nomogram)模型。方法:收集2013年7月至2020年12月在中山市人民医院泌尿外科行RC且满足条件的112例患者的临床资料。使用受试者工作特征(ROC)曲线计算术前SUA最佳分界值,并分为高、低SUA组。通过Cox回归筛选影响RC患者OS的独立危险因素,并构建Nomogram模型。结果:SUA最佳截断值为373μmol/L。低SUA组患者术后OS明显优于高SUA组(P<0.01),两组患者T分期、病理分级、肿瘤大小及生存情况比较差异均有统计学意义(P<0.05)。T分期、病理分级、肿瘤数目、肿瘤大小、术前SUA是影响RC患者OS的独立危险因素(P<0.05)。对Nomogram模型进行内部验证,证实该模型具有良好的区分度、准确度和临床获益。结论:术前SUA可独立影响RC患者的OS,基于SUA构建的Nomogram模型对RC患者OS率有一定预测价值,可为患者术后早期辅助治疗和制定随访方案提供参考。

Objective:To investigate the relationship between preoperative serum uric acid(SUA)level and overall survival(OS)of patients undergoing radical cystectomy(RC),and to construct a nomogram for predicting the OS rate of RC patients.Methods:The clinical data of 112 patients who underwent RC in the Department of Urol-ogy of Zhongshan City People's Hospital from July 2013 to December 2020 and met the eligibility criteria were collect-ed.The optimal cut-off value of preoperative SUA was calculated using the receiver operator characteristic(ROC)curve and divided into high and low SUA groups.Independent risk factors affecting OS in RC patients were screened by Cox regression,and a nomogram model was constructed.Results:The optimal cut-off value of SUA was 373μmol/L.The postoperative OS of patients in the low SUA group was significantly better than that in the high SUA group(P<0.01),and there were significantly statistical differences between the two groups in terms of T stage,path-ological grading,tumor size,and survival(P<0.05).T stage,pathological grading,tumor number,tumor size,and preoperative SUA were independent risk factors affecting the OS of RC patients(P<0.05).Internal validation of the nomogram model evidence confirmed that the model had good discrimination,accuracy and clinical benefit.Conclu-sion:Preoperative SUA can independently affect the OS of RC patients,and the nomogram constructed on the basis of SUA has a certain predictive value for the OS rate of RC patients,which can provide a reference for the early post-operative adjuvant treatment of patients and the development of follow-up programs.