Zhang Xue-Li, Zhang Chen, Lang Lu, Yi Jia-Wen, Zhu Min, Zhang Yu-Hui
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Respiratory and Critical Care Medicine, Beijing Shunyi Hospital, Beijing, China.
Thorac Cancer. 2025 May;16(9):e70076. doi: 10.1111/1759-7714.70076.
This study aimed to analyze the association between baseline serum uric acid (SUA) level and venous thromboembolism (VTE) and clinical outcomes in patients with non-small cell lung cancer (NSCLC).
We conducted a prospective analysis of 626 patients with newly diagnosed or recurrent/progressive NSCLC between September 2021 and August 2024. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff values for risk factors related to VTE, and clinical characteristics and treatment outcomes were collected and compared according to these values. Fine-Gray regression analyses were used to identify the risk factors of VTE, and survival was analyzed using log-rank test and Cox regression analysis.
In the study, 72 patients (11.50%) experienced VTE. Patients with VTE had a higher baseline SUA level than those without VTE (p = 0.000). The optimal threshold of baseline SUA to predict VTE was 310 μmol/L. The incidence of VTE was higher in the high SUA group than that of the low SUA group (19.1% vs. 7.9%, p < 0.001). In multivariable analysis, the baseline SUA level was associated with the risk of VTE (sub-distribution hazard ratio (SHR) = 2.830, 95% CI 1.689-4.742, p = 0.000). Additionally, the higher SUA level was associated with a worse disease-free survival (DFS) in newly diagnosed patients with NSCLC staged I-IIIA (adjusted HR = 1.948, 95% CI 1.121-3.384, p = 0.018).
Among NSCLC patients, a baseline feature of high SUA (≥ 310 μmol/L) was associated with an increased risk of VTE and a worse clinical outcome.
本研究旨在分析非小细胞肺癌（NSCLC）患者的基线血清尿酸（SUA）水平与静脉血栓栓塞症（VTE）及临床结局之间的关联。
我们对2021年9月至2024年8月期间626例新诊断或复发/进展期NSCLC患者进行了前瞻性分析。采用受试者工作特征（ROC）曲线确定与VTE相关的危险因素的最佳临界值，并根据这些值收集和比较临床特征及治疗结局。使用Fine-Gray回归分析确定VTE的危险因素，并采用对数秩检验和Cox回归分析进行生存分析。
在本研究中，72例患者（11.50%）发生了VTE。发生VTE的患者基线SUA水平高于未发生VTE的患者（p = 0.000）。预测VTE的基线SUA最佳阈值为310μmol/L。高SUA组的VTE发生率高于低SUA组（19.1%对7.9%，p < 0.001）。在多变量分析中，基线SUA水平与VTE风险相关（亚分布风险比（SHR）= 2.830，95%置信区间1.689 - 4.742，p = 0.000）。此外，较高的SUA水平与I-IIIA期新诊断NSCLC患者较差的无病生存期（DFS）相关（校正风险比（HR）= 1.948，95%置信区间1.121 - 3.384，p = 0.018）。
在NSCLC患者中，高SUA（≥310μmol/L）的基线特征与VTE风险增加及较差的临床结局相关。
