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Agtas G, Alkan A, Tanriverdi Ö. Serum uric acid level can predict asymptomatic brain metastasis at diagnosis in patients with small cell lung cancer. J Egypt Natl Canc Inst 2024; 36:28. [PMID: 39343808 DOI: 10.1186/s43046-024-00235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/25/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND The aim of this study was to determine the relationship between serum uric acid level at diagnosis and asymptomatic brain metastasis in patients with extensive-stage small cell lung cancer. METHODS A total of 69 patients with extensive-stage small cell lung cancer without symptomatic brain metastases, whose serum uric acid level was measured at the time of diagnosis, were included in this retrospective cross-sectional study. The patients were divided into two groups as those with and without asymptomatic brain metastases. The Mann-Whitney U test was used for comparison between groups, and Spearman's correlation test was used for correlation analysis. The cut-off level of serum uric acid level was analyzed, and sensitivity, specificity, and accuracy rates were determined for brain metastasis. Independent factors affecting asymptomatic brain metastasis were determined by multivariate Cox regression analysis. RESULTS The median serum uric acid level of all patients was 6.9 mg/dL. Twenty-two percent of patients had asymptomatic brain metastases, and serum uric acid levels were significantly higher in these patients (P = 0.0014). The cut-off value for serum uric acid level was calculated as 6.2 mg/dL. The sensitivity, specificity, and accuracy of this value for brain metastasis were 84%, 76%, and 78%, respectively. High serum uric acid level was an independent risk factor for asymptomatic brain metastasis (OR 3.446 95% CI 1.337-5.480; P = 0.005). CONCLUSION In conclusion, a serum uric acid level of 6.2 mg/dL and above at the time of diagnosis may predict asymptomatic brain metastasis in patients.
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Affiliation(s)
- Gizem Agtas
- Faculty of Medicine, Mugla Sıtkı Koçman University, Muğla, Turkey
| | - Ali Alkan
- Department of Medical Oncology and Oncological Clinical Research Center, Mugla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Özgür Tanriverdi
- Department of Medical Oncology and Oncological Clinical Research Center, Mugla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey.
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Alkan A, Doğaner Gİ, Tanrıverdi Ö. Serum Uric Acid Level May Be a Predictive Factor for BRAF V600E Mutation in Older Patients with Metastatic Colorectal Cancer: An Exploratory Analysis. Oncology 2024:1-8. [PMID: 38952125 DOI: 10.1159/000539981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
INTRODUCTION This study aimed to show the relationship between the serum uric acid level measured at diagnosis and the BRAF mutation status in the primary tumor tissue in patients with metastatic colorectal cancer. METHODS In this retrospective cross-sectional study, 264 patients (64% male) whose serum uric acid level was measured at the time of diagnosis and whose BRAF mutation status in the primary tumor was determined were included. RESULTS The BRAF mutation rate was 14% (n = 37). The median serum uric acid levels of all patients were 6.9 mg/dL (25%, 75% percentile range 3.7, 8.2). The serum uric acid level cut-off value was 6.6 mg/dL. Sensitivity and specificity for BRAF mutated patients were 84% and 27%, respectively. These rates were calculated as 85% and 70% in BRAF-mutated patients aged 65 and over. There was a significant correlation between BRAF mutation and high serum uric acid level, female gender, tumor located in the ascending colon, and multiple metastatic sites. The independent factors affecting BRAF mutation were age 65 and over, tumor in the ascending colon, and high serum uric acid level. CONCLUSION As a result, we concluded that high serum uric acid level measured during diagnosis in metastatic colorectal cancer is an accessible and economical biomarker that can predict BRAF mutation in patients aged 65 and over.
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Affiliation(s)
- Ali Alkan
- Department of Medical Oncology and Oncological Clinical Research Center, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
- Muğla Sıtkı Koçman University Graduate School of Medical Sciences, Elderly Health PhD Program, Muğla, Turkey
| | | | - Özgür Tanrıverdi
- Department of Medical Oncology and Oncological Clinical Research Center, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
- Muğla Sıtkı Koçman University Graduate School of Medical Sciences, Elderly Health PhD Program, Muğla, Turkey
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Yan J, Zhu C. Hyperuricemia is a Adverse Prognostic Factor for Colon Cancer Patients. Int J Gen Med 2021; 14:3001-3006. [PMID: 34234529 PMCID: PMC8254611 DOI: 10.2147/ijgm.s314834] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Objective Hyperuricemia is linked to the prognosis of a number of cancers; however, its association with colon cancer survival has not been fully elucidated. To investigate whether hyperuricemia affects the prognosis of colon cancer, we conducted a retrospective study. Methods The study included age- and sex-matched colon cancer patients, of whom 60 patients were diagnosed with hyperuricemia, and 120 patients did not have hyperuricemia. The overall survival (OS) and disease-free survival (DFS) of these patients were evaluated by Kaplan–Meier (K-M) analysis. The association between the survival of colon cancer patients and hyperuricemia was analyzed using the Cox regression method after adjusting for tumor stage and grade and vascular infiltration. Results The K-M survival analysis supported that patients with hyperuricemia had poor OS (P for the Log rank test = 0.0008) and DFS. As demonstrated by the univariate analysis, the presence of hyperuricemia was correlated with decreased OS (HROS = 2.09, P = 0.002). Tumor grade and tumor stage were also found to be independent predictors for the prognosis of colon cancer patients. In addition, poor OS among patients with hyperuricemia was also confirmed in the adjusted analysis (HROS = 1.94, P = 0.005). Conclusion Hyperuricemia has an adverse effect on the prognosis and survival of patients with colon cancer. Further studies evaluating the cellular and molecular mechanisms are needed to validate the prognostic value of hyperuricemia in colon cancer.
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Affiliation(s)
- Jiang Yan
- Department of General Surgery, Liyang People's Hospital Affiliated to Nantong University, Liyang, 213300, People's Republic of China
| | - Chuming Zhu
- Department of General Surgery, Liyang People's Hospital Affiliated to Nantong University, Liyang, 213300, People's Republic of China
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Jiang M, Ren L, Chen S, Li G. Serum Uric Acid Levels and Risk of Eight Site-Specific Cancers: A Mendelian Randomization Study. Front Genet 2021; 12:608311. [PMID: 33767728 PMCID: PMC7985250 DOI: 10.3389/fgene.2021.608311] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/15/2021] [Indexed: 12/27/2022] Open
Abstract
The relationship between serum uric acid (UA) levels and cancer risk remains controversial. Here, a two-sample Mendelian randomization analysis was performed to identify a causal effect of serum UA levels on cancer risk. Twenty-six single nucleotide polymorphisms strongly associated with serum UA levels were screened as genetic variants from large-scale meta-analysis data of a genome-wide association study of 110,347 European individuals. Genetic associations with eight common site-specific cancers were subsequently explored. A total of six Mendelian randomization methods were used to estimate the potential effect of serum UA levels on cancer risk, including random effects inverse variance weighting, fix effects inverse variance weighting, MR-Egger, median weighting, mode weighting, and simple mode analysis. Our primary random effects inverse variance weighted analysis revealed that no significant associations with cancers was found (all p > 0.05). Sensitivity analyses and additional analyses also showed similar pooled results. In conclusion, no significant causality between serum UA levels and cancer risk was evidenced.
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Affiliation(s)
- Minxiao Jiang
- Department of Urology, Sir Run-Run Shaw Hospital College of Medicine, Zhejiang University, Hangzhou, China
| | - Liangliang Ren
- Department of Urology, Sir Run-Run Shaw Hospital College of Medicine, Zhejiang University, Hangzhou, China
| | - Songzan Chen
- Department of Cardiology, Key Laboratory of Biotherapy of Zhejiang Province, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Gonghui Li
- Department of Urology, Sir Run-Run Shaw Hospital College of Medicine, Zhejiang University, Hangzhou, China
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The Lipase/Amylase Ratio (LAR) in Peripheral Blood Might Represent a Novel Prognostic Marker in Patients with Surgically Resectable Pancreatic Cancer. Cancers (Basel) 2020; 12:cancers12071798. [PMID: 32635610 PMCID: PMC7408133 DOI: 10.3390/cancers12071798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/26/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022] Open
Abstract
Pancreatic enzymes might play a pivotal role in the pathophysiology and prognosis of pancreatic cancer. The aim of this study is to investigate the lipase/amylase ratio (LAR), representing a marker previously used in the differentiation of pancreatitis, as a potential prognostic marker in pancreatic cancer. Data from 157 surgically treated patients with ductal pancreatic adenocarcinoma and 351 patients with metastatic disease were evaluated retrospectively. Cancer-specific survival (CSS) was considered the endpoint of the study. After applying Kaplan-Meier curve analysis, uni- and multivariate Cox regression models were calculated to evaluate the prognostic relevance of LAR. An elevated LAR at diagnosis of localized pancreatic cancer was significantly associated with higher CA19-9 levels (p < 0.05). In univariate analysis, we observed an increased LAR as a significant factor for lower CSS in localized pancreatic cancer patients (HR = 1.63; 95% CI = 1.12-2.36; p = 0.01), but not in metastatic patients (HR = 1.12; 95% CI = 0.87-1.43; p = 0.363). In multivariate analysis, including age, gender, tumor stage, Karnofsky Performance Status, tumor grade, administration of chemotherapy and the LAR, an increased LAR was confirmed to represent an independent prognostic factor regarding CSS (HR = 1.81; 95% CI = 1.17-2.77; p = 0.007) in localized pancreatic cancer patients. In conclusion, our study identified the LAR as an independent prognostic factor in surgically treated pancreatic cancer patients.
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Liao H, Zhao S, Wang H, Liu Y, Zhang Y, Sun G. Self-Assembly Of Retinoid Nanoparticles For Melanoma Therapy. Int J Nanomedicine 2019; 14:7963-7973. [PMID: 31632011 PMCID: PMC6778447 DOI: 10.2147/ijn.s196974] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 07/27/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Amphiphilic fusion drugs are covalent conjugates of a lipophilic drug and a hydrophilic drug or their active fragments. These carrier-free self-assembly nanomaterials are helpful to co-deliver two synergic drugs to the same site regardless of pharmacokinetic properties of individual drugs. Retinoic hydroxamic acid (RHA) is a "fusion drug" of all-trans retinoic acid (ATRA) and vorinostat, a histone deacetylase (HDAC) inhibitor showing synergic effect with ATRA on cancer therapy. Although RHA was synthesized in 2005, its nanoscale self-assembly property, anticancer activity, and possible related mechanism are still unclear. METHODS RHA nanoparticles were observed under transmission electron microscope (TEM). Both in vitro cell viability, colony formation assay, and in vivo xenograft mouse tumor model were employed here to study anticancer activity of RHA nanoparticles. The putative synergic anticancer mechanism of activating retinoic acid receptor (RAR) and inhibiting HDAC were investigated via receptor inhibitor rescue assay and in vitro enzyme activity assay, respectively. RESULTS RHA could form nanoparticle formation by self-assembly and abrogates growth of several solid tumor cell lines even after RHA nanoparticles' washout. However, opposite to our initial hypothesis, pre-treating the melanoma cells with RAR antagonists showed no impact on inhibitory effect of RHA nanoparticles, which suggested that the target of the molecule on melanoma cells is not RAR and retinoid X receptor (RXR). Importantly, RHA nanoparticles inhibited the growth of xenograft tumors without obvious impact on haematological indexes and hepatorenal function of these tumor-bearing mice. CONCLUSION Our findings demonstrate the promise of RHA nanoparticles in treating malignant melanoma tumors with high efficacy and low toxicity.
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Affiliation(s)
- Han Liao
- Scientific Research Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian116023, People’s Republic of China
- University of Chinese Academy of Sciences, Beijing100049, People’s Republic of China
| | - Shan Zhao
- Scientific Research Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian116023, People’s Republic of China
- University of Chinese Academy of Sciences, Beijing100049, People’s Republic of China
| | - Huihui Wang
- Scientific Research Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian116023, People’s Republic of China
- University of Chinese Academy of Sciences, Beijing100049, People’s Republic of China
| | - Yang Liu
- Scientific Research Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian116023, People’s Republic of China
| | - Ying Zhang
- Scientific Research Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian116023, People’s Republic of China
| | - Guangwei Sun
- Scientific Research Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian116023, People’s Republic of China
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Prochazka KT, Melchardt T, Posch F, Schlick K, Deutsch A, Beham-Schmid C, Weiss L, Gary T, Neureiter D, Klieser E, Greil R, Neumeister P, Egle A, Pichler M. NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients. Br J Cancer 2016; 115:1264-1272. [PMID: 27764838 PMCID: PMC5104895 DOI: 10.1038/bjc.2016.325] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 12/22/2022] Open
Abstract
Background: Blood-based parameters are gaining increasing interest as potential prognostic biomarkers in patients with diffuse large B-cell lymphoma (DLBCL). The aim of this study was to comprehensively evaluate the prognostic significance of pretreatment plasma uric acid levels in patients with newly diagnosed DLBCL. Methods: The clinical course of 539 DLBCL patients, diagnosed and treated between 2004 and 2013 at two Austrian high-volume centres with rituximab-based immunochemotherapy was evaluated retrospectively. The prognostic influence of uric acid on overall survival (OS) and progression-free survival (PFS) were studied including multi-state modelling, and analysis of conditional survival. Results: Five-year OS and PFS were 50.4% (95% CI: 39.2–60.6) and 44.0% (33.4–54.0) in patients with uric acid levels above the 75th percentile of the uric acid distribution (Q3, cut-off: 6.8 mg dl−1), and 66.2% (60.4–71.5) and 59.6% (53.7–65.0%) in patients with lower levels (log-rank P=0.002 and P=0.0045, respectively). In univariable time-to-event analysis, elevated uric acid levels were associated with a worse PFS (hazard ratio (HR) per 1 log increase in uric acid 1.47, 95% CI: 1.10–1.97, P=0.009) and a worse OS (HR=1.60, 95% CI: 1.16–2.19, P=0.004). These associations prevailed upon multivariable adjustment for the NCCN-IPI score. Uric acid levels significantly improved the predictive performance of the R-IPI and NCCN-IPI scores, and in multi-state analysis, it emerged as a highly significant predictor of an increased risk of death without developing recurrence (transition-HR=4.47, 95% CI: 2.17–9.23, P<0.0001). Conclusions: We demonstrate that elevated uric acid levels predict poor long-term outcomes in DLBCL patients beyond the NCCN-IPI risk index.
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Affiliation(s)
- Katharina T Prochazka
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Thomas Melchardt
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Florian Posch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Konstantin Schlick
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Alexander Deutsch
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | | | - Lukas Weiss
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Thomas Gary
- Division of Angiology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Richard Greil
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Peter Neumeister
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Alexander Egle
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Martin Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria.,Research Unit for non-coding RNAs and genome editing in cancer, Graz 8036, Austria.,Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
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Battelli MG, Polito L, Bortolotti M, Bolognesi A. Xanthine oxidoreductase in cancer: more than a differentiation marker. Cancer Med 2016; 5:546-57. [PMID: 26687331 PMCID: PMC4799950 DOI: 10.1002/cam4.601] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/05/2015] [Accepted: 11/08/2015] [Indexed: 12/17/2022] Open
Abstract
Human xanthine oxidoreductase (XOR) catalyzes the last two steps of purine catabolism and is present in two interconvertible forms, which may utilize O2 or NAD(+) as electron acceptors. In addition to uric acid, XOR products may comprise reactive oxygen and nitrogen species that have many biologic effects, including inflammation, endothelial dysfunction, and cytotoxicity, as well as mutagenesis and induction of proliferation. XOR is strictly modulated at the transcriptional and post-translational levels, and its expression and activity are highly variable in cancer. Xanthine oxidoreductase (XOR) expression has been negatively associated with a high malignity grade and a worse prognosis in neoplasms of the breast, liver, gastrointestinal tract, and kidney, which normally express a high level of XOR protein. However, the level of XOR expression may be associated with a worse outcome in cancer of low XOR-expressing cells, in relation to the inflammatory response elicited through the tissue damage induced by tumor growth. Xanthine oxidoreductase (XOR) has been implicated in the process of oncogenesis either directly because it is able to catalyze the metabolic activation of carcinogenic substances or indirectly through the action of XOR-derived reactive oxygen and nitrogen species. The role of uric acid is characterized by both oxidant and antioxidant action; thus, it is still debatable whether control of uricemia may be helpful to improve the outcomes of tumor illness.
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Affiliation(s)
- Maria Giulia Battelli
- Department of Experimental, Diagnostic and Specialty Medicine – DIMESAlma Mater Studiorum – University of Bologna, General Pathology UnitVia S. Giacomo 1440126BolognaItaly
| | - Letizia Polito
- Department of Experimental, Diagnostic and Specialty Medicine – DIMESAlma Mater Studiorum – University of Bologna, General Pathology UnitVia S. Giacomo 1440126BolognaItaly
| | - Massimo Bortolotti
- Department of Experimental, Diagnostic and Specialty Medicine – DIMESAlma Mater Studiorum – University of Bologna, General Pathology UnitVia S. Giacomo 1440126BolognaItaly
| | - Andrea Bolognesi
- Department of Experimental, Diagnostic and Specialty Medicine – DIMESAlma Mater Studiorum – University of Bologna, General Pathology UnitVia S. Giacomo 1440126BolognaItaly
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Hyperuricemia has an adverse impact on the prognosis of patients with osteosarcoma. Tumour Biol 2015; 37:1205-10. [PMID: 26282000 DOI: 10.1007/s13277-015-3830-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 07/21/2015] [Indexed: 01/23/2023] Open
Abstract
Patients with osteosarcoma have poor prognosis and are often at high risk of death. Identification of prognostic biomarkers for osteosarcoma may aid in improving the survival. Hyperuricemia had been suggested as a poor prognostic factor of several cancers, but the prognostic role of hyperuricemia in osteosarcoma patients had not been assessed. In the present study, we investigated the prognostic role of hyperuricemia at baseline on the overall survival of patients with osteosarcoma. Sixty osteosarcoma patients with hyperuricemia were matched (1:2) to 120 osteosarcoma patients without hyperuricemia with similar age and gender. Data from those patients with osteosarcoma were evaluated retrospectively. The role of hyperuricemia on overall survival was firstly analyzed using the Kaplan-Meier method. Univariate and multivariate Cox regression models were also used to further evaluate the prognostic significance of hyperuricemia. None of the clinicopathological parameters except distant metastasis was associated with hyperuricemia. Kaplan-Meier method showed that patients with hyperuricemia had shorter overall survival compared with those with normouricemia (P < 0.0001, log-rank test). In univariate analysis, hyperuricemia was associated with poorer overall survival in osteosarcoma patients (HR = 2.71, 95 % CI 1.75-4.20; P < 0.0001). In the multivariate analysis, after adjusting for age, gender, serum alkaline phosphatase, stage, tumor size, and metastasis, hyperuricemia was independently associated with poorer overall survival in osteosarcoma patients (HR = 2.28, 95 % CI 1.41-3.69; P = 0.001). In conclusion, hyperuricemia at baseline is associated with poorer overall survival in osteosarcoma patients, and it has an adverse impact on the prognosis of osteosarcoma patients.
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