尿酸在预测头颈部癌患者根治性放疗后转移中的预后价值
Prognostic Value of Uric Acid in Predicting Metastasis Following Definitive Radiotherapy in Patients With Head and Neck Cancer.
作者信息
Lee Sangmin, Li Xue, Kim Jin Ho, Wu Hong-Gyun, Eom Keun Yong, Lee Joo Ho
机构信息
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
出版信息
In Vivo. 2025 Jul-Aug;39(4):2464-2473. doi: 10.21873/invivo.14047.
BACKGROUND/AIM: This study investigated the prognostic value of serum uric acid (SUA) levels after definitive radiotherapy (RT) in head and neck cancer (HNC).
PATIENTS AND METHODS
This retrospective study included patients with HNC undergoing definitive RT between January 2008 and February 2019. SUA levels were measured pre- and post-RT. Survival outcomes were analyzed using the Kaplan-Meier method, log-rank tests, and multivariable Cox regression. The optimal post-RT SUA cut-off (4.6 mg/dl) was determined ROC analysis.
RESULTS
A total of 185 patients were analyzed, with a median follow-up of 63.3 months. The mean pre-treatment SUA level was 5.4 mg/dl, which decreased to 5.2 mg/dl post-treatment, though the difference was not statistically significant (=0.326). A post-treatment SUA cut-off of 4.6 mg/dl demonstrated discriminatory ability for distant metastasis-free survival (DMFS) but was not predictive of overall survival or locoregional relapse-free survival (LRFS). Kaplan-Meier analysis showed that patients with post-treatment SUA ≥4.6 mg/dl had significantly poorer DMFS than those with lower levels [hazard ratio (HR)=1.25, 95% confidence interval (CI)=1.02-1.53; =0.004]. Multivariable analysis confirmed post-treatment SUA ≥4.6 mg/dl (HR=5.01, =0.010), HPV-negative oropharyngeal tumors (HR=5.68, =0.025), and Stage IV disease (HR=4.10, =0.020) as independent prognostic factors for DMFS.
CONCLUSION
Post-treatment SUA levels may serve as a potential marker for predicting metastasis following RT in HNC.
背景/目的：本研究调查了头颈部癌（HNC）根治性放疗（RT）后血清尿酸（SUA）水平的预后价值。
患者与方法
这项回顾性研究纳入了2008年1月至2019年2月期间接受根治性放疗的HNC患者。在放疗前后测量SUA水平。使用Kaplan-Meier法、对数秩检验和多变量Cox回归分析生存结果。通过ROC分析确定放疗后SUA的最佳临界值（4.6mg/dl）。
结果
共分析了185例患者，中位随访时间为63.3个月。治疗前SUA平均水平为5.4mg/dl，治疗后降至5.2mg/dl，尽管差异无统计学意义（P=0.326）。放疗后SUA临界值为4.6mg/dl对无远处转移生存期（DMFS）具有鉴别能力，但不能预测总生存期或无局部区域复发生存期（LRFS）。Kaplan-Meier分析显示，放疗后SUA≥4.6mg/dl的患者DMFS明显低于水平较低的患者[风险比（HR）=1.25，95%置信区间（CI）=1.02-1.53；P=0.004]。多变量分析证实放疗后SUA≥4.6mg/dl（HR=5.01，P=0.010）、人乳头瘤病毒（HPV）阴性口咽肿瘤（HR=5.68，P=0.025）和IV期疾病（HR=4.10，P=0.020）是DMFS的独立预后因素。
结论
放疗后SUA水平可能作为预测HNC放疗后转移的潜在标志物。
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