The Role Of Serum Uric Acid And Uric Acid To Albumin Ratio For Predicting Of Lymph Node Metastasis In Lung Cancer Treated Surgically By Vats
DOI:
https://doi.org/10.48729/pjctvs.249Keywords:
Non-small cell lung cancer, VATS, lobectomy, segmentectomy, uric acidAbstract
Objectives: In recent years, a correlation between prognosis of various cancers and inflammation has been emphasized in many studies. Uric acid which is a purine metabolite is one of the serum inflammation markers. Albumin is a major component of serum protein and it is used as a parameter reflecting nutritional status and cancer aggressiveness. Here, we have investigated whether preoperative serum uric acid levels, albumin levels, and uric acid to albumin ratio predict lymph node metastasis in non-small cell lung cancer treated surgically by VATS.
Methods: The medical records of patients underwent VATS lobectomy-segmentectomy for non-small cell lung cancer between January 2015 and December 2020, were reviewed retrospectively. Cut-off values of preoperative serum uric acid, albumin and uric acid to albumin ratio were determined by Receiver Operating Characteristics (ROC) analysis. Groups with and without lymph node metastasis were created according to hilar and/or mediastinal lymph node metastasis. In addition, high and low groups were created according to preoperative uric acid levels and uric acid to albumin ratio. Pearson chi-square test was used investigate whether any significant correlation between the groups.
Results: A total of 115 patients were included in the study. Lymph node metastasis in N1 and N2 stations was detected in 11 and 18 patients, respectively. Cut-off values for uric acid and uric acid to albumin ratio were 5.97 mg/dL and 1.28x10-3, respectively. There was a statistically significant correlation between lymph node metastasis and high uric acid levels (p=0.008, OR: 3.2) and high uric acid to albumin ratio (p=0.03, OR: 2.6).
Conclusion: Preoperative serum uric acid and uric acid to albumin ratio can predict the lymph node metastasis in non-small cell lung cancer treated surgically by video assisted thoracic surgery.
Downloads
References
Bille A, Woo KM, Ahmad U, Rizk NP, Jones DR. Incidence of occult pN2 disease following resection and mediastinal lymph node dissection in clinical stage I lung cancer patients. Eur J Cardiothorac Surg 2017;51:674-679.
Łochowski M, Chałubi ska-Fendler J, Zawadzka IK, Łochowska B, R bowski M, et al. The prognostic significance of preoperative platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients operated for non-small cell lung cancer. Cancer Management and Research2021;13:7795-7802.
Łochowski M, Łochowska B, Chałubi ska-Fendler J, Zawadzka I, R bowski M, Kozak J. Prognostic factors determining survival of patients operated for non-small cell lung cancer with consideration given to morphological parameters of blood. Cancer Manag Res 2021;13:479-487.
Ames BN, Cathcart R, Schwiers E, Hochstein P. Uric acid provides an antioxidant defense in humans against oxidant and radicalcaused aging and cancer: a hypothesis. Proc Natl Acad Sci USA 1981;78:6858-6862.
Petersson B, Trell E. Raised serum urate concentration as risk factor for premature mortality in middle aged men: relation to death from cancer. Br Med J (Clin Res Ed) 1983;287:7-9.
Fini MA, Elias A, Johnson RJ, Wright RM. Contribution of uric acid to cancer risk, recurrence, and mortality. Clin Transl Med
;1:16.
Boffetta P, Nordenvall C, Nyrén O, Ye W. A prospective study of
gout and cancer. Eur J Cancer Prev 2009;18:127-132.
Huang CF, Huang JJ, Mi NN, Lin YY, He QS, et al. Associations between serum uric acid and hepatobiliary-pancreatic cancer: A
cohort study. World J Gastroenterol 2020;26:7061-7075.
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.
Pan M, Zhao Y, He J, Wu H, Pan Y, et al. Prognostic value of
the glasgow prognostic score on overall survival in patients with advanced non-small cell lung cancer. J Cancer 2021;12:2395-2402.
Takamori S, Takada K, Shimokawa M, Matsubara T, Fujishita T, et al. Clinical utility of pretreatment Glasgow prognostic score in non-small-cell lung cancer patients treated with immune checkpoint inhibitors. Lung Cancer 2021;152:27-33.
Vaz Souza R, Bassi M, Mantovani S, Poggi C, Diso D, et al. Comparison of preoperative scores predicting outcome in elderly undergoing lung malignancies resection. J Thorac Dis 2020;12:7083-7088.
Ustuner MA, Dogan L. Relationship of preoperative serum uric acid level with survival in colorectal cancer. J Coll Physicians Surg Pak 2020;30:717-721.
Chen YF, Li Q, Chen DT, Pan JH, Chen YH, et al. Prognostic value of pre-operative serum uric acid levels in esophageal squamous cell carcinoma patients who undergo R0 esophagectomy. Cancer Biomark 2016;17:89-96.
YangZ,LiS,ZhaoL,LvW,JuJ,etal.Serumuricacidto lymphocyte ratio: A novel prognostic biomarker for surgically resected early-stage lung cancer. A propensity score matching analysis. Clin Chim Acta 2020;503:35-44.
Tanriverdi O, Cokmert S, Oktay E, Pilanci KN, Menekse S, 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. Med Oncol 2014;31:217.
Shi Y. Caught red-handed: uric acid is an agent of inflammation. J Clin Invest. 2010;120:1809-1811.
Mi S, Gong L, Sui Z. Friend or foe? An unrecognized role of uric acid in cancer development and the potential anticancer effects of uric acid-lowering drugs. Journal of Cancer 2020;11:5236-5244.
Yan S, Zhang P, Xu W, Liu Y, Wang B, Jiang T. et al. Serum uric acid increases risk of cancer incidence and mortality: a systematic review and meta-analysis. Mediators Inflamm2015;2015:764250.
Fiala O, Pesek M, Finek J, Racek J, Minarik M, et al. Serum albumin is a strong predictor of survival in patients with advanced-stage non-small cell lung cancer treated with erlotinib. Neoplasma 2016;63:471-476.
Li X, Qin S, Sun X, Liu D, Zhang B, et al. Prognostic significance of albumin-globulin score in patients with operable non-small-cell lung cancer. Ann Surg Oncol 2018;25:3647-3659.
Downloads
Published
How to Cite
License
Copyright (c) 2023 Portuguese Journal of Cardiac Thoracic and Vascular Surgery
This work is licensed under a Creative Commons Attribution 4.0 International License.
