血清尿酸及C反应蛋白与恶性实体肿瘤临床分期的关系
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摘要
目的探讨血清尿酸(UA)及C反应蛋白(CRP)与恶性实体肿瘤临床分期的关系。方法选取恶性实体肿瘤患者573例为肿瘤组,同期健康体检者200例为对照组,比较两组对象初诊时血清UA及CRP水平,同时分析其对肿瘤临床分期的影响。结果肿瘤组血清UA、CRP水平均明显高于对照组(均P<0.05)。肺癌、大肠癌、卵巢癌、胃癌、食管癌、乳腺癌(绝经前、后期)不同临床分期患者血清UA及CRP水平比较,差异均有统计学意义(均P<0.05),均为Ⅲ～Ⅳ期患者高于Ⅰ～Ⅱ期患者。血清UA及CRP水平是肺癌(OR=1.584,95%CI:1.016～2.085;OR=1.955,95%CI:1.586～2.301)、乳腺癌(OR=1.262,95%CI:0.963～1.493;OR=1.807,95%CI:1.655～2.189)、大肠癌(OR=1.343,95%CI:1.251～1.466;OR=1.819,95%CI:1.332～2.415)临床分期的影响因素。结论初诊时血清UA及CRP水平是肺癌、乳腺癌、大肠癌临床分期的影响因素。
Objective To investigate the relationships of serum uric acid(UA) and C-reactive protein(CRP) with clinical staging of cancer patients. Methods The clinical data of 573 cancer patients were retrospectively reviewed, and 200 healthy subjects served as control group. The levels of UA and CRP were compared between cancer patients and control group.Meanwhile, the association of UA and CRP with clinical staging of cancer patients was analyzed. Results The cancer patients had higher levels of UA and CRP than control group(both P<0.05). The patients with lung cancer, colon cancer, stomach cancer, ovarian cancer, esophagus cancer and postmenopausal breast cancer in Ⅲ/Ⅳ stage all had higher levels of UA and CRP than those in Ⅰ/Ⅱ stage(all P<0.05). Logistic analysis showed that UA(OR=1.584, 95%CI:1.016-2.085, P<0.05) and CRP(OR=1.955, 95% CI:1.586-2.301, P <0.05) were negatively associated with lung cancer staging. UA(OR=1.262, 95% CI:0.963-1.493, P<0.05) and CRP(OR=1.807, 95%CI:1.655-2.189, P<0.05) were negatively associated with breast cancer staging. UA(OR=1.343, 95%CI:1.251-1.466, P<0.05) and CRP(OR=1.819, 95%CI:1.332-2.415, P<0.05) negatively associated with colon cancer staging. Conclusion The levels of UA and CRP are correlated with clinical staging of lung cancer, colon cancer and breast cancer.
Objective To investigate the relationships of serum uric acid(UA) and C-reactive protein(CRP) with clinical staging of cancer patients. Methods The clinical data of 573 cancer patients were retrospectively reviewed, and 200 healthy subjects served as control group. The levels of UA and CRP were compared between cancer patients and control group.Meanwhile, the association of UA and CRP with clinical staging of cancer patients was analyzed. Results The cancer patients had higher levels of UA and CRP than control group(both P<0.05). The patients with lung cancer, colon cancer, stomach cancer, ovarian cancer, esophagus cancer and postmenopausal breast cancer in Ⅲ/Ⅳ stage all had higher levels of UA and CRP than those in Ⅰ/Ⅱ stage(all P<0.05). Logistic analysis showed that UA(OR=1.584, 95%CI:1.016-2.085, P<0.05) and CRP(OR=1.955, 95% CI:1.586-2.301, P <0.05) were negatively associated with lung cancer staging. UA(OR=1.262, 95% CI:0.963-1.493, P<0.05) and CRP(OR=1.807, 95%CI:1.655-2.189, P<0.05) were negatively associated with breast cancer staging. UA(OR=1.343, 95%CI:1.251-1.466, P<0.05) and CRP(OR=1.819, 95%CI:1.332-2.415, P<0.05) negatively associated with colon cancer staging. Conclusion The levels of UA and CRP are correlated with clinical staging of lung cancer, colon cancer and breast cancer.
引文
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[16]Yuan C,Xu XH,Wang XL,et al.Relationship between serum uric acid and metastatic and nonmetastatic rectal cancer patients with undergoing no chemotherapy[J].Medicine,2016,95(47):e5463.DOI:10.1097/MD.0000000000005463.
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[18]Chen YF,Li Q,Chen DT,et al.Prognostic value of pre-operative serum uric acid levels in esophageal squamous cell carcinoma patients who undergo R0 esophagectomy[J].Cancer Biomark,2016,17(1):89-96.DOI:10.3233/CBM-160621.
[19]Tanriverdi O,Cokmert S,Oktay E,et al.Prognostic significance of the baseline serum uric acid level in non-small cell lung cancer patients treated with first-line chemotherapy:a study of the Turkish Descriptive Oncological Researches Group[J].Med Oncol,2014,31(10):217.DOI:10.1007/s12032-014-0217-z.
[2]Kelly EE.Effect of plasma uric acid on antioxidant capacity,oxidative stress,and insulin sensitivity in obese subjects[J].Diabetes,2014,63(9):e18.DOI:10.2337/db140-740.
[3]Baldwin W,Mc Rae S.Hyperuricemia as a mediator of theproinflammatory endocrine imbalance in the adipose tissue in a murine model of the metabolic syndrome[J].Diabetes,2011,60(4):1258-1269.DOI:10.2337/db10-0916.
[4]Kang DH,Ha SK.Uric Acid Puzzle:Dual Role as Anti-oxidantand Pro-oxidant[J].Electrolytes&Blood Pressure,2014,12(1):1-6.DOI:10.5049/EBP.2014.12.1.1.
[5]Ghaemi-Oskouie F,Shi Y.The role of uric acid as an endogenous danger signal in immunity and inflammation[J].Curr Rheumatol Rep,2011,13(2):160-166.DOI:10.1007/s11926-011-0162-1.
[6]Rampazzo C,Tozzi MG,Dumontet C,et al.The druggability of intracellular nucleotide-degrading enzymes[J].Cancer Chemother Pharmacol,2016,77:883-893.DOI:10.1007/s00280-015-2921-6.
[7]Linder N,Butzow R,Lassus H,et al.Decreased xanthine oxidoreductase(XOR)is associated with a worse prognosis in patients with serous ovarian carcinoma[J].Gynecol Oncol,2012,124(2):311-318.DOI:10.1016/j.ygyno.2011.10.026.
[8]Li G,Cong L,Gasser J.Mechanisms underlying the anti-proliferative actions of adiponectin in human breast cancer cells,MCF7-dependency on the c AMP/protein kinase-A pathway[J].Nutr Cancer,2011,63:80-88.DOI:10.1080/01635581.2010.516472.
[9]Hristova MG.Neuroendocrine and immune disequilibrium as a probable link between metabolic syndrome and carcinogenesis[J].Med Hypotheses,2018,118:1-5.DOI:10.1016/j.mehy.2018.05.018.
[10]Maria D,Kalliope N.The Role of Adiponectin in Cancer:A Review of Current Evidence[J].Endocr Rev,2012,33(4):547-594.DOI:10.1210/er.2011-1015.
[11]Mendon,a FM,de Sousa FR,Barbosa AL,et al.Metabolic syndrome and risk of cancer:which link?[J].Metabolism,2015,64:182-189.DOI:10.1016/j.metabol.2014.10.008.
[12]Strasak AM,Lang S,Kneib T,et al.Use of penalized splines in extended Cox-type additive hazard regression to flexibly estimate the effect of time-varying serum uric acid on risk of cancer incidence:a prospective,population based study in 78850 men[J].Ann Epidemiol,2009,19(1):15-24.DOI:10.1016/j.annepidem.2008.08.009.
[13]Strasak AM,Rapp K,Hilbe W,et al.The role of serumuric acid as an antioxidant protecting against cancer:prospective study in more than 28000 older Austrian women[J].Ann Oncol,2007,18(11):1893-1897.DOI:10.1093/annonc/mdm338.
[14]Dovell F,Boffetta P.Serum uric acid and cancer mortality and incidence:a systematic review and meta-analysis[J].Eur J Cancer Prev,2015,27(4):399-405.DOI:10.1097/CEJ.0000000000000440.
[15]Cetin AO,Omar M,Calp S,et al.Hyperuricemia at The Time of Diagnosis is a Factor for Poor Prognosis in Patients With Stage IIand III Colorectal Cancer[J].Asian Pac J Cancer Prev,2017,18(2):485-490.DOI:10.22034/APJCP.2017.18.2.485.
[16]Yuan C,Xu XH,Wang XL,et al.Relationship between serum uric acid and metastatic and nonmetastatic rectal cancer patients with undergoing no chemotherapy[J].Medicine,2016,95(47):e5463.DOI:10.1097/MD.0000000000005463.
[17]Selcukbiricik F,Kanbay M,Solak Y,et al.Serum uric acid as a surrogate marker of favorable response to bevacizuman treatment in patients with metastic colon cancer[J].Clin Transl Oncol,2016,18(11):1082-1087.DOI:10.1007/s12094-016-1485-1.
[18]Chen YF,Li Q,Chen DT,et al.Prognostic value of pre-operative serum uric acid levels in esophageal squamous cell carcinoma patients who undergo R0 esophagectomy[J].Cancer Biomark,2016,17(1):89-96.DOI:10.3233/CBM-160621.
[19]Tanriverdi O,Cokmert S,Oktay E,et al.Prognostic significance of the baseline serum uric acid level in non-small cell lung cancer patients treated with first-line chemotherapy:a study of the Turkish Descriptive Oncological Researches Group[J].Med Oncol,2014,31(10):217.DOI:10.1007/s12032-014-0217-z.